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Higher-Dose Maintenance With ERZOFRI 351 mg in Adults With Schizophrenia (ELEVATE)

4 novembre 2026 aggiornato da: Alejandro Alva

Exploratory Evaluation of ERZOFRI (Paliperidone Palmitate) 351 mg Q4W Maintenance in Higher-Need Patients With Schizophrenia: Clinical Global Improvement, Drug-Induced Parkinsonism, and Sexual Dysfunction Outcomes Over a 3-Month Treatment Period

This is a prospective, multicenter, open-label, single-arm study evaluating ERZOFRI (paliperidone palmitate) 351 mg administered every 4 weeks as maintenance treatment in approximately 40 adults with schizophrenia who experience symptom worsening before their next scheduled monthly injection despite receiving paliperidone palmitate 234 mg every 4 weeks.

Participants will receive ERZOFRI 351 mg on Day 1, Week 4, and Week 8 and will complete an end-of-study assessment at Week 12. The study will evaluate changes in clinical severity over 12 weeks and will also assess movement-related side effects and sexual functioning.

Panoramica dello studio

Stato

Non ancora reclutamento

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

40

Fase

  • Fase 4

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

    • California
      • Orange, California, Stati Uniti, 92866
        • ATP Clinical Research
        • Contatto:
        • Investigatore principale:
          • Alejandro Alva, MD
    • Florida
      • Miami, Florida, Stati Uniti, 33127
        • Passageway Residences of Dade County
        • Investigatore principale:
          • Ilan Melnick, MD
    • Illinois
      • Chicago, Illinois, Stati Uniti, 60641
        • Pillar Clinical Research
        • Investigatore principale:
          • Roueen Rafeyan, MD

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 65 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  1. Adults aged 18-65 years with a DSM-5 diagnosis of schizophrenia.
  2. Currently receiving monthly paliperidone palmitate long-acting injectable (INVEGA SUSTENNA or ERZOFRI) at a dose of 234 mg every 4 weeks (Q4W) for at least 3 consecutive months before Screening.
  3. Clinician-documented symptom breakthrough, destabilization, or functional deterioration occurring before the scheduled 4-week injection interval during at least 2 of the 3 most recent monthly injection cycles (not necessarily consecutive). Documentation may include progress notes indicating symptom worsening in the final week before the next injection, unscheduled clinic or emergency department visits for psychiatric symptoms, as-needed medication use for breakthrough psychosis, or clinician judgment based on longitudinal care.
  4. Documented prior tolerability to oral paliperidone or oral risperidone.
  5. Clinical Global Impression-Severity (CGI-S) score ≥3 (mildly ill) and ≤6 (severely ill) at Baseline.
  6. Able and willing to independently provide written informed consent.

Exclusion Criteria:

  1. Known hypersensitivity to paliperidone, risperidone, or any ERZOFRI formulation excipient.
  2. Renal impairment, defined as creatinine clearance (CrCl) <50 mL/min.
  3. Hemoglobin A1c (HbA1c) ≥7.0% at Screening.
  4. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥2 times the upper limit of normal (ULN) at Screening.
  5. Body mass index (BMI) >43 kg/m² at Screening.
  6. QT interval corrected using Fridericia's formula (QTcF) >450 milliseconds (ms) for males or >470 ms for females at Screening. A QTcF ≥480 ms is exclusionary regardless of sex.
  7. Other clinically significant electrocardiogram abnormalities, including serious ventricular arrhythmias, clinically significant conduction abnormalities, or evidence of unstable cardiovascular disease, as determined by the investigator.
  8. Other metabolic abnormalities or medical conditions that, in the investigator's judgment, represent active, uncontrolled disease that could compromise participant safety or suitability for study participation.
  9. Current or recent (within the past 30 days) participation in another interventional clinical trial.
  10. Severe substance use disorder within the past 6 months, according to DSM-5 criteria.
  11. Pregnant or breastfeeding women, or women of childbearing potential who are unwilling or unable to comply with protocol-specified contraception requirements throughout study participation and for 45 days following the final study injection.
  12. History of neuroleptic malignant syndrome (NMS) or tardive dyskinesia (TD) requiring treatment discontinuation.
  13. Current use of strong CYP3A4 and/or P-glycoprotein (P-gp) inducers, including carbamazepine, rifampin, or St. John's Wort.
  14. Imminent risk of harm to self or others, as assessed by the investigator.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: ERZOFRI 351 mg Q4W

Participants will receive ERZOFRI 351 mg by intramuscular injection on Day 1, Week 4, and Week 8, followed by an end-of-study assessment at Week 12.

Paliperidone palmitate extended-release injectable suspension (ERZOFRI) 351 mg administered by intramuscular injection on Day 1, Week 4, and Week 8. The Day 1 injection will be administered in the deltoid muscle; subsequent injections may be administered in the deltoid or gluteal muscle.

Altri nomi:
  • ERZOFRI

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Mean Change From Baseline to Week 12 in Clinical Global Impression-Severity (CGI-S) Score
Lasso di tempo: Baseline (Day 1) and Week 12

Change in clinician-rated CGI-S score from Baseline (Day 1) to Week 12. The CGI-S is a 7-point scale assessing overall severity of mental illness, ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill patients). Negative changes from baseline indicate improvement.

Baseline (Day 1) and Week 12

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Patient Clinical Global Impression-Improvement (PCGI-I) Response
Lasso di tempo: Weeks 4, 8, and 12

Proportion of participants reporting a PCGI-I score ≤2 ("much improved" or "very much improved"). The PCGI-I is a 7-point patient-reported measure of perceived global improvement, ranging from 1 (very much improved) to 7 (very much worse). Lower scores indicate greater improvement.

Weeks 4, 8, and 12
Change From Baseline in Simpson-Angus Scale (SAS) Total Score
Lasso di tempo: Baseline, Week 4, Week 8, and Week 12

Change from baseline in total SAS score. The SAS is a 10-item clinician-rated scale assessing parkinsonian signs. Each item is scored from 0 (normal) to 4 (extreme), with total scores ranging from 0 to 40; higher scores indicate greater severity of parkinsonian symptoms.

Baseline, Week 4, Week 8, and Week 12
Change From Baseline in Abnormal Involuntary Movement Scale (AIMS) Items 1-7 Total Score
Lasso di tempo: Baseline, Week 4, Week 8, and Week 12

Change from baseline in the total score for AIMS Items 1-7. The AIMS is a clinician-rated scale assessing involuntary movements involving the facial/oral regions, extremities, and trunk. Items 1-7 are each scored from 0 (none) to 4 (severe), with higher scores indicating greater severity of involuntary movements. The total score for Items 1-7 ranges from 0 to 28.

Baseline, Week 4, Week 8, and Week 12
Correlation Between Serum Prolactin Concentration and Arizona Sexual Experience Scale (ASEX) Total Score
Lasso di tempo: Week 12

Correlation between serum prolactin concentration (ng/mL) and sexual dysfunction assessed using the Arizona Sexual Experience Scale (ASEX) at Week 12. The ASEX is a five-item questionnaire with total scores ranging from 5 to 30; higher scores indicate greater sexual dysfunction. The relationship will be evaluated using Pearson or Spearman correlation coefficients, as appropriate.

Week 12
Clinical Global Impression-Improvement (CGI-I) Response
Lasso di tempo: Weeks 4, 8, and 12

Proportion of participants achieving a CGI-I score ≤2 ("much improved" or "very much improved"). The CGI-I is a 7-point clinician-rated scale assessing overall clinical improvement relative to baseline, ranging from 1 (very much improved) to 7 (very much worse). Lower scores indicate greater improvement.

Weeks 4, 8, and 12
Change From Baseline in Arizona Sexual Experience Scale (ASEX) Total Score
Lasso di tempo: Baseline, Weeks 4, 8, and 12

Change from baseline in ASEX total score at Weeks 4, 8, and 12. The ASEX is a five-item questionnaire assessing sexual functioning, with total scores ranging from 5 to 30. Higher scores indicate greater sexual dysfunction.

Baseline, Weeks 4, 8, and 12

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Lasso di tempo: Day 1 through Week 12

Number and proportion of participants experiencing treatment-emergent adverse events during the study, with adverse event severity summarized.

Day 1 through Week 12
Change From Screening to Week 12 in Serum Prolactin Concentration
Lasso di tempo: Screening and Week 12

Change in serum prolactin concentration (ng/mL) from Screening to Week 12 during treatment with ERZOFRI 351 mg Q4W.

Screening and Week 12
Mean Change From Baseline in Fasting Glucose
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in fasting blood glucose concentration, measured in mg/dL.

Baseline and Week 12
Injection-Site Pain Severity Score
Lasso di tempo: Day 1, Weeks 4 and 8

Severity of injection-site pain following ERZOFRI administration, assessed by the investigator using an 11-point numerical rating scale ranging from 0 (no pain) to 10 (most severe pain). Higher scores indicate greater severity.

Day 1, Weeks 4 and 8
Mean Change From Baseline in QTcF Interval
Lasso di tempo: Baseline, Weeks 4, 8, and 12

Change from baseline in the QT interval corrected using Fridericia's formula (QTcF), measured in milliseconds (ms), as assessed by 12-lead electrocardiogram (ECG).

Baseline, Weeks 4, 8, and 12
All-Cause Study Discontinuation
Lasso di tempo: Day 1 through Week 12

Number and proportion of participants who discontinue the study before Week 12, with reasons for discontinuation summarized.

Day 1 through Week 12
Symptom Breakthrough Before the 4-Week Injection Interval
Lasso di tempo: Day 1 through Week 12

Proportion of participants experiencing symptom breakthrough before the scheduled 4-week injection interval during the study period, compared with their documented pre-enrollment rate of symptom breakthrough.

Day 1 through Week 12
Number of Unscheduled Clinic Visits for Psychiatric Symptoms
Lasso di tempo: Day 1 through Week 12

Total number of unscheduled clinic visits related to psychiatric symptoms occurring during the 12-week study period.

Day 1 through Week 12
Mean Change From Baseline in Body Weight
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in body weight, measured in kilograms (kg).

Baseline and Week 12
Mean Change From Baseline in Body Mass Index (BMI)
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in body mass index (BMI), calculated as body weight in kilograms divided by height in meters squared (kg/m²).

Baseline and Week 12
Mean Change From Baseline in Waist Circumference
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in waist circumference, measured in centimeters (cm).

Baseline and Week 12
Mean Change From Baseline in Total Cholesterol
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in serum total cholesterol concentration, measured in mg/dL.

Baseline and Week 12
Mean Change From Baseline in HDL Cholesterol
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in high-density lipoprotein (HDL) cholesterol concentration, measured in mg/dL.

Baseline and Week 12
Mean Change From Baseline in LDL Cholesterol
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in low-density lipoprotein (LDL) cholesterol concentration, measured in mg/dL.

Baseline and Week 12
Mean Change From Baseline in Triglycerides
Lasso di tempo: Baseline and Week 12

Change from baseline to Week 12 in serum triglyceride concentration, measured in mg/dL.

Baseline and Week 12
Injection-Site Swelling Severity Score
Lasso di tempo: Day 1, Weeks 4 and 8

Severity of injection-site swelling following ERZOFRI administration, assessed by the investigator using an 11-point numerical rating scale ranging from 0 (no swelling) to 10 (most severe swelling). Higher scores indicate greater severity.

Day 1, Weeks 4 and 8
Injection-Site Redness Severity Score
Lasso di tempo: Day 1, Weeks 4 and 8

Severity of injection-site redness following ERZOFRI administration, assessed by the investigator using an 11-point numerical rating scale ranging from 0 (no redness) to 10 (most severe redness). Higher scores indicate greater severity.

Day 1, Weeks 4 and 8
Number of Emergency Department Visits for Psychiatric Symptoms
Lasso di tempo: Day 1 through Week 12

Total number of emergency department visits related to psychiatric symptoms occurring during the 12-week study period.

Day 1 through Week 12
Number of Psychiatric Hospitalizations
Lasso di tempo: Day 1 through Week 12

Total number of psychiatric hospitalizations occurring during the 12-week study period.

Day 1 through Week 12

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Alejandro Alva, MD, PNS Clinical Research LLC dba ATP Clinical Research

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 dicembre 2026

Completamento primario (Stimato)

1 dicembre 2027

Completamento dello studio (Stimato)

1 dicembre 2027

Date di iscrizione allo studio

Primo inviato

9 ottobre 2026

Primo inviato che soddisfa i criteri di controllo qualità

4 novembre 2026

Primo Inserito (Effettivo)

10 novembre 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

10 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

4 novembre 2026

Ultimo verificato

1 novembre 2026

Maggiori informazioni

Termini relativi a questo studio

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

prodotto fabbricato ed esportato dagli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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