边缘性人格障碍中的Caplyta
Caplyta 治疗边缘性人格障碍的双盲、安慰剂对照研究
研究概览
详细说明
边缘性人格障碍 (BPD) 是一种严重的、难以治疗的精神障碍,会导致严重的情绪困扰,并给医疗保健系统带来沉重的经济负担。 各种心理疗法,特别是辩证行为疗法 (DBT) 和情绪可预测性和问题解决系统训练 (STEPPS),已显示出有助于减少 BPD 的许多核心症状。 然而,医疗保健系统通常缺乏实施这些治疗的资金和适当的专业知识,而且对于许多 BPD 患者来说,找到训练有素的 DBT 或 STEPPS 治疗师一直很困难。 虽然对药物使用的研究正在进行中,但美国或其他地方尚未批准任何药物用于治疗 BPD。 抗抑郁药、抗惊厥药和第二代抗精神病药都经过了检查,但目前 BPD 的药物选择通常只能部分缓解症状,而且可能有明显的副作用。
BPD 的特点是严重的精神病理症状普遍存在,情绪调节、冲动控制和攻击性不稳定。 5-羟色胺能、多巴胺能和谷氨酸能系统的功能障碍已在与该病症相关的症状中得到证实,并被认为是可能的原因。 因此,Caplyta(lumateperone)具有独特的特性,使其成为 BPD 患者的一个有前途的选择。 Caplyta 是一种机制新颖的药物,因为它同时调节血清素、多巴胺和谷氨酸,这是与 BPD 相关的关键神经递质。 具体来说,Caplyta 是一种有效的血清素 5-HT2A 受体拮抗剂、多巴胺 D2 受体突触前部分激动剂和突触后拮抗剂、D1 受体依赖性谷氨酸调节剂和血清素再摄取抑制剂。 此外,由于副作用发生率低,Caplyta 应该是一种耐受性良好且实际上是 BPD 理想的药物治疗方法。
本研究的目的是检查 Caplyta 与安慰剂对成年 BPD 患者的疗效和安全性,正如 Zanarini 边缘人格障碍评定量表(“Zanarini 量表”)中至少 9 分所表明的那样,该量表疾病严重程度,在基线就诊时。
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Illinois
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Chicago、Illinois、美国、60637
- University Of Chicago Medical Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
描述
纳入标准:
- 18-65岁的男女;
- BPD的初步诊断
- 基线时 Zanarini 量表得分至少为 9
- 目前至少在进入研究前的最后 2 个月接受某种形式的每周认知行为治疗
- 理解和签署同意书的能力。
排除标准:
- 基于病史的不稳定内科疾病或基线体格检查的临床显着异常
- 患有精神分裂症或 I 型双相情感障碍的受试者
- 患有活性物质使用障碍的受试者
- 目前怀孕或哺乳,或育龄妇女避孕措施不充分
- 根据哥伦比亚自杀严重程度评定量表 (C-SSRS) (www.cssrs.columbia.edu/docs),受试者被认为有直接自杀风险
- 基于尿液毒理学筛查的非法物质使用(考虑到 BPD 中大麻使用率高且与 Caplyta 缺乏相互作用,不包括大麻)。
- 在研究开始前的最后 3 个月内开始使用任何新的精神药物
- 以前用Caplyta治疗
- 干扰理解和自我管理药物或提供书面知情同意的能力的认知障碍
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 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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安慰剂比较:安慰剂
从研究的第一周开始,所有被随机分配到安慰剂组的受试者将接受与实验药物相同的安慰剂药丸。
将每两周对受试者进行一次观察,持续 8 周。
研究结束后(第 8 周),将停止服药。
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不含药物的药丸。
其他名称:
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实验性的:Caplyta
从研究的第一周开始,所有被随机分配到 Caplyta 的受试者将接受 42mg/天的剂量。
将每两周对受试者进行一次观察,持续 8 周。
不允许更改和减少剂量。
研究结束后(第 8 周),将停止服药。
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非典型抗精神病药
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Change in Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) Total Score
大体时间:8 weeks
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The ZAN-BPD is a clinician-administered scale assessing borderline personality disorder symptom severity (total scores range from 0-36).
Higher scores indicate more severe symptoms.
The ZAN-BPD will be administered at all 5 visits, but only the change from baseline to visit 5 at week 8 will be reported.
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8 weeks
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Change in Modified Overt Aggression Scale (MOAS) Total Score
大体时间:8 weeks
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The MOAS is a clinician-administered behavior rating scale measuring four types of aggressive behavior.
The MOAS will be administered at all 5 visits, but only the change from baseline to visit 5 at week 8 will be reported.
The total weighted scores range from 0-40, with 0 indicating no aggression.
Higher total scores indicate higher aggression levels.
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8 weeks
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Change in Young Mania Rating Scale (YMRS) Total Score
大体时间:8 weeks
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The YMRS is a clinician-administered, 11-item scale assessing manic symptoms at baseline and over time.
The YMRS will be administered at all 5 visits, but only the change from baseline to visit 5 at week 8 will be reported.
Higher total scores (ranging from 0-60) indicate higher severity of manic symptoms.
This scale is used to rate the severity of manic abnormality in participants.
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8 weeks
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Change in Zanarini Rating Scale for Borderline Personality Disorder Self-Report Version (ZAN-BPD-SRV) Total Score
大体时间:8 weeks
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The ZAN-BPD-SRV is a self-report scale assessing borderline personality severity that will be assessed at all 5 visits.
However, only the change from baseline to visit 5 at week 8 will be reported.
Scoring is done by counting the number of yes's.
Total scores range from 0-36, with higher scores indicating more severe symptoms.
A score of 8 or more is indicative of a diagnosis of borderline personality disorder.
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8 weeks
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Change in Barratt Impulsiveness Scale (BIS-11) Total Score
大体时间:8 weeks
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This BIS-11 is a self-report assessment of impulsivity that will be assessed at baseline and Visit 5.
The change from baseline to visit 5 at week 8 will be reported.
All items are added to result in a total score ranging from 30-120.
Higher total scores indicate higher impulsiveness.
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8 weeks
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Change in Hamilton Depression Rating Scale (HAM-D) Total Score
大体时间:8 weeks
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The HAM-D is a clinician-administered assessment of depression that will be assessed at all 5 study visits.
However, only the change from baseline to visit 5 at week 8 will be reported.
Higher total scores (ranging from 0-52) indicate higher levels of depression, while a score of 0 would indicate no depressive symptoms.
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8 weeks
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Change in Hamilton Anxiety Rating Scale (HAM-A) Total Score
大体时间:8 weeks
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The HAM-A is a clinician-administered assessment of anxiety that will be assessed at all 5 study visits.
However, only the change from baseline to visit 5 at week 8 will be reported.
Higher total scores (ranging from 0-56) indicate higher levels of anxiety, with 0 being no symptoms of anxiety.
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8 weeks
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Change in Quality of Life Inventory (QOLI) Total Weighted Satisfaction Score
大体时间:8 weeks
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The QOLI is a self-report assessment of patient perceived quality of life that will be assessed at baseline and visit 5.
The change in total weighted satisfaction scores from baseline to visit 5 at week 8 will be reported.
Higher scores (ranging from -96 to 96) indicate a higher quality of life, whereas lower scores indicate a lower quality of life.
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8 weeks
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Change in Sheehan Disability Scale (SDS) Total Score
大体时间:8 weeks
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Subjects will complete the SDS at all 5 visits.
The change in total scores (ranging from 0-30) from baseline to visit 5 at week 8 will be assessed.
The scale itself assesses the level of disability from borderline personality disorder (or target disorder) with higher scores indicating a more debilitating disorder.
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8 weeks
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Change in Borderline Evaluation of Severity Over Time (BEST) Total Score
大体时间:8 weeks
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The BEST is a self-rated scale used to measure severity and change.
The first 12 items of the scale are scored on a scale from 1-5, with 5 meaning that the item caused extreme distress, severe difficulties in relationships, and/or kept the participant from getting things done.
The lowest rating (1) means it caused little or no problems.
Items 13-15 (positive behaviors) are rated according to frequency.
Items 13-15 are rated 1-5 with 5 indicating more frequent symptoms.
The scale ranges from 12-72 with higher scores indicating more severe symptoms.
The score for items 1-12 are added together, the score from items 13-15 are then subtracted, and then 15 is added to obtain the total score.
The BEST will be administered at all 5 visits, but only the change from baseline to visit 5 at week 8 will be reported.
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8 weeks
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Minnesota Impulsive Disorders Interview (MIDI)
大体时间:Baseline
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The MIDI is a clinical interview that screens for a variety of impulsive disorders, including buying disorder, kleptomania, trichotillomania, intermittent explosive disorder, pyromania, gambling disorder, compulsive sexual behavior, binge eating disorder, and compulsive exercise.
The results of the MIDI at baseline will be reported.
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Baseline
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合作者和调查者
调查人员
- 首席研究员:Jon E Grant, MD, JD, MPH、University of Chicago
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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