A Study of the Efficacy (Effectiveness) of Paliperidone Palmitate in the Prevention of Recurrence of the Symptoms of Schizophrenia.
A Randomized Double-blind Placebo-controlled Parallel Group Study Evaluating Paliperidone Palmitate in the Prevention of Recurrence in Patients With Schizophrenia. Placebo Consists of 20% Intralipid (200 mg/mL) Injectable Emulsion.
The purpose of this study is to evaluate the efficacy of paliperidone palmitate compared with placebo in the prevention of recurrence of the symptoms of schizophrenia and to assess the safety and tolerability of paliperidone palmitate in patients with stable and symptomatic schizophrenia.
The placebo used in this study was a nutritional substance known as 20% Intralipid emulsion given to patients requiring intravenous feedings.
研究概览
详细说明
Many patients with schizophrenia have difficulty adhering to a daily oral treatment regimen.
Long-acting injectable formulations, such as long-acting injectable paliperidone palmitate, may provide therapeutic plasma concentrations over several weeks, thereby eliminating the need for daily oral medication and making compliance easier.
This study is a randomized (patients will be assigned to different treatment groups based solely on chance), double-blind (neither the patient nor the physician will know if placebo or drug is being given and at what dose), placebo-controlled, parallel-group, multicenter study followed by an open-label extension period in patients with schizophrenia.
The study is designed to evaluate the efficacy of paliperidone palmitate (a long-acting injectable formulation) in delaying the time to and decreasing the rate of recurrence compared with placebo in patients with schizophrenia.
The study will consist of 5 periods: an up to 7-day screening/washout/tolerability period, a 9-week open-label transition period, a 24-week open-label maintenance period, a randomized, variable-length double-blind, placebo-controlled recurrence prevention period, and an up to 52-week open-label extension period.
Patients will have intramuscular (i.m.) study drug injections and efficacy and safety evaluations performed every 4 weeks throughout the study.
Efficacy will be evaluated during the study using a recurrence assessment, the Positive and Negative Symptom Scale for Schizophrenia (PANSS), the Clinical Global Impression - Severity (CGI-S) scale, and the Personal and Social Performance (PSP) scale.
Safety will be assessed throughout the study by monitoring adverse events; use of extrapyramidal symptoms (EPS) rating scales (Abnormal Involuntary Movement Scale [AIMS], Barnes Akathisia Rating Scale [BARS], Simpson Angus Scale [SAS]); clinical laboratory testing; vital signs (temperature, blood pressure, and heart rate) measurements; electrocardiograms (ECGs); and physical examinations.
Additionally, the patients will assess the tolerability of the injections by evaluating the pain of the injection and the pain at the injection sites.
Tolerability test: 3 mg/day of oral ER OROS paliperidone for 4 days.
Transition (9 wks): 50 mg eq.
paliperidone palmitate i.m. dose on Day 1, then i.m. injections (25, 50, or 100 mg eq.) once every 4 wks (q4wk).
Maintenance (24-wks): paliperidone palmitate i.m. injections (25, 50, or 100 mg eq.) q4wk.
Recurrence Prevention: paliperidone palmitate i.m. injections (25, 50, or 100 mg eq. or placebo) q4wk.
Open-label paliperidone palmitate (25, 50, 75, or 100 mg eq.) q4wk for 12 dosing periods.
研究类型
介入性
注册 (实际的)
414
阶段
- 第三阶段
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
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Dnepropetrovsk、乌克兰
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Glevakha、乌克兰
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Kharkiv、乌克兰
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Kiev、乌克兰
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Kyiv、乌克兰
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Lvov、乌克兰
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Odessa、乌克兰
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Simferopol、乌克兰
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Vinnitsa、乌克兰
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Arkhangelsk、俄罗斯联邦
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Moscow、俄罗斯联邦
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Moscow N/A、俄罗斯联邦
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Moscow Russia、俄罗斯联邦
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Samara N/A、俄罗斯联邦
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St Petersburg N/A、俄罗斯联邦
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Yaroslavl、俄罗斯联邦
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Cape Town、南非
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Centurion Gauteng、南非
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Florida Johannesburg Gauteng、南非
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Johannesburg、南非
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Changhua、台湾
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Kaohsiung、台湾
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Tainan、台湾
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Taoyuan、台湾
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Costa Rica、哥斯达黎加
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Ciudad De Mexico、墨西哥
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Merida、墨西哥
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Monterrey、墨西哥
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Gwangju、大韩民国
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Inchun、大韩民国
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Pusan、大韩民国
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Seoul、大韩民国
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Bucharest、罗马尼亚
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Bucuresti、罗马尼亚
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Cluj-Napoca、罗马尼亚
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Iasi、罗马尼亚
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Sibiu、罗马尼亚
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Tg Mures、罗马尼亚
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Timisoara、罗马尼亚
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Arkansas
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Little Rock、Arkansas、美国
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California
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Cerritos、California、美国
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Santa Ana、California、美国
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Florida
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Hialeah、Florida、美国
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Illinois
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Chicago、Illinois、美国
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Granite City、Illinois、美国
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Louisiana
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Lake Charles、Louisiana、美国
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Shreveport、Louisiana、美国
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Mississippi
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Flowood、Mississippi、美国
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Missouri
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St. Louis、Missouri、美国
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New Jersey
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Clementon、New Jersey、美国
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New York
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Cedarhurst、New York、美国
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Ohio
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Cleveland、Ohio、美国
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Oklahoma
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Oklahoma City、Oklahoma、美国
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Texas
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Conroe、Texas、美国
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Desoto、Texas、美国
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Irving、Texas、美国
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San Antonio、Texas、美国
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参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 65年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Patients who meet the diagnostic criteria for schizophrenia according to DSM-IV-TM for at least 1 year before screening
- have a PANSS score of <120
- have a body mass index (BMI) >/=15.0 kilogram (kg)/meter (m)2
- and have resided at the same address for at least 30 days
Exclusion Criteria:
- Patients unable to provide their own consent
- have been involuntarily committed to psychiatric hospitalization
- have primary, active DSM-IV-TM diagnosis other than schizophrenia
- who have a DSM-IV-TM diagnosis of active substance dependence within 3 months before screening (nicotine and caffeine are not exclusionary)
- have a history of treatment resistance as defined by failure to respond to 2 adequate trials (minimum of 4 weeks at a therapeutic dose) of different antipsychotic medications
- have a history of any severe preexisting gastrointestinal narrowing or inability to swallow the medication whole with water
- have a history of neuroleptic malignant syndrome (NMS)
- are at significant risk of suicidal or violent behavior
- current presence of any significant or unstable medication condition
- treatment with any protocol disallowed therapies
- clinically significant result from screening laboratory or ECG.
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:四人间
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:001
Paliperidone Palmitate 25, 50, 75 or 100 mg eq every 4 wk for up to 24 mo
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25, 50, 75 or 100 mg eq every 4 wk for up to 24 mo
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安慰剂比较:002
Placebo Placebo every 4 wk up to 24 mo
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Placebo every 4 wk up to 24 mo
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
The primary efficacy criteria for this study is the time from randomization to the first recurrence event during the double-blind recurrence prevention period
大体时间:After 68 relapse events
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After 68 relapse events
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次要结果测量
结果测量 |
大体时间 |
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Changes from randomization to the end of the recurrence prevention period in PANSS (total and subscales), CGI-S, and PSP. Incidence of adverse events, labs and ECGs throughout study.
大体时间:After 68 relapse events
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After 68 relapse events
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Ceraso A, Lin JJ, Schneider-Thoma J, Siafis S, Tardy M, Komossa K, Heres S, Kissling W, Davis JM, Leucht S. Maintenance treatment with antipsychotic drugs for schizophrenia. Cochrane Database Syst Rev. 2020 Aug 11;8(8):CD008016. doi: 10.1002/14651858.CD008016.pub3.
- Mathews M, Gopal S, Singh A, Nuamah I, Pungor K, Tan W, Soares B, Kim E, Savitz AJ. Comparison of Relapse Prevention with 3 Different Paliperidone Formulations in Patients with Schizophrenia Continuing versus Discontinuing Active Antipsychotic Treatment: A Post-Hoc Analysis of 3 Similarly Designed Randomized Studies. Neuropsychiatr Dis Treat. 2020 Jun 19;16:1533-1542. doi: 10.2147/NDT.S221242. eCollection 2020.
- Weiden PJ, Kim E, Bermak J, Turkoz I, Gopal S, Berwaerts J. Does Half-Life Matter After Antipsychotic Discontinuation? A Relapse Comparison in Schizophrenia With 3 Different Formulations of Paliperidone. J Clin Psychiatry. 2017 Jul;78(7):e813-e820. doi: 10.4088/JCP.16m11308.
- Emsley R, Nuamah I, Gopal S, Hough D, Fleischhacker WW. Relapse After Antipsychotic Discontinuation in Schizophrenia as a Withdrawal Phenomenon vs Illness Recurrence: A Post Hoc Analysis of a Randomized Placebo-Controlled Study. J Clin Psychiatry. 2018 Jun 19;79(4):17m11874. doi: 10.4088/JCP.17m11874.
- Kozma CM, Slaton T, Dirani R, Fastenau J, Gopal S, Hough D. Changes in schizophrenia-related hospitalization and ER use among patients receiving paliperidone palmitate: results from a clinical trial with a 52-week open-label extension (OLE). Curr Med Res Opin. 2011 Aug;27(8):1603-11. doi: 10.1185/03007995.2011.595000. Epub 2011 Jun 22.
- Hough D, Gopal S, Vijapurkar U, Lim P, Morozova M, Eerdekens M. Paliperidone palmitate maintenance treatment in delaying the time-to-relapse in patients with schizophrenia: a randomized, double-blind, placebo-controlled study. Schizophr Res. 2010 Feb;116(2-3):107-17. doi: 10.1016/j.schres.2009.10.026. Epub 2009 Dec 2.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2005年2月1日
初级完成 (实际的)
2007年2月1日
研究完成 (实际的)
2008年2月1日
研究注册日期
首次提交
2005年5月17日
首先提交符合 QC 标准的
2005年5月17日
首次发布 (估计)
2005年5月18日
研究记录更新
最后更新发布 (估计)
2014年6月20日
上次提交的符合 QC 标准的更新
2014年6月19日
最后验证
2014年6月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.