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

2026年11月4日 更新者: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.

調査の概要

状態

まだ募集していません

研究の種類

介入

入学 (推定)

40

段階

  • フェーズ 4

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

    • California
      • Orange、California、アメリカ、92866
        • ATP Clinical Research
        • コンタクト:
        • 主任研究者:
          • Alejandro Alva, MD
    • Florida
      • Miami、Florida、アメリカ、33127
        • Passageway Residences of Dade County
        • 主任研究者:
          • Ilan Melnick, MD
    • Illinois
      • Chicago、Illinois、アメリカ、60641
        • Pillar Clinical Research
        • 主任研究者:
          • Roueen Rafeyan, MD

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~65年 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:なし
  • 介入モデル:単一グループの割り当て
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的: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.

他の名前:
  • ERZOFRI

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Mean Change From Baseline to Week 12 in Clinical Global Impression-Severity (CGI-S) Score
時間枠: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

二次結果の測定

結果測定
メジャーの説明
時間枠
Patient Clinical Global Impression-Improvement (PCGI-I) Response
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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

その他の成果指標

結果測定
メジャーの説明
時間枠
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠:Day 1 through Week 12

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

Day 1 through Week 12

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:Alejandro Alva, MD、PNS Clinical Research LLC dba ATP Clinical Research

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年12月1日

一次修了 (推定)

2027年12月1日

研究の完了 (推定)

2027年12月1日

試験登録日

最初に提出

2026年10月9日

QC基準を満たした最初の提出物

2026年11月4日

最初の投稿 (実際)

2026年11月10日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月10日

QC基準を満たした最後の更新が送信されました

2026年11月4日

最終確認日

2026年11月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

はい

米国FDA規制機器製品の研究

いいえ

米国で製造され、米国から輸出された製品。

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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