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

4 november 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Beräknad)

40

Fas

  • Fas 4

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

  • Förenta staterna
    • California
      • Orange, California, Förenta staterna, 92866
        • ATP Clinical Research
        • Kontakt:
        • Huvudutredare:
          • Alejandro Alva, MD
    • Florida
      • Miami, Florida, Förenta staterna, 33127
        • Passageway Residences of Dade County
        • Huvudutredare:
          • Ilan Melnick, MD
    • Illinois
      • Chicago, Illinois, Förenta staterna, 60641
        • Pillar Clinical Research
        • Huvudutredare:
          • Roueen Rafeyan, MD

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 65 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Läkemedel: Paliperidone Palmitate

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.

Andra namn:
  • ERZOFRI

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Mean Change From Baseline to Week 12 in Clinical Global Impression-Severity (CGI-S) Score
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Patient Clinical Global Impression-Improvement (PCGI-I) Response
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: Day 1 through Week 12

Total number of psychiatric hospitalizations occurring during the 12-week study period.
Day 1 through Week 12

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Alejandro Alva

Samarbetspartners

Luye Pharma Group Ltd.

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 december 2026

Primärt slutförande (Beräknad)

1 december 2027

Avslutad studie (Beräknad)

1 december 2027

Studieregistreringsdatum

Först inskickad

9 oktober 2026

Först inskickad som uppfyllde QC-kriterierna

4 november 2026

Första postat (Faktisk)

10 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

10 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

4 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • ELEVATE

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

produkt tillverkad i och exporterad från U.S.A.

Nej

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