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A Study of the Cataractogenic Potential of Seroquel and Risperdal in the Treatment of Participants With Schizophrenia or Schizoaffective Disorder

A Multicenter, Open Label, Flexible-dose, Parallel-group Evaluation of the Cataractogenic Potential of Quetiapine Fumarate (Seroquel) and Risperidone (Risperdal) in the Long Term Treatment of Participants With Schizophrenia or Schizoaffective Disorder

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00206102
Enrollment
1098
Registered
2005-09-21
Start date
2003-09-30
Completion date
2008-10-31
Last updated
2013-01-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Schizoaffective Disorder, Schizophrenia

Keywords

Schizophrenia, Schizoaffective Disorder

Brief summary

This Phase IV, randomized, parallel-group study is designed to evaluate the cataractogenic potential of quetiapine fumarate (SEROQUEL) compared with that of a putative non-cataractogenic antipsychotic medication risperidone (RISPERDAL). This study is being conducted to fulfill the SEROQUEL Phase IV commitment regarding evaluation of cataractogenic potential.

Interventions

DRUGquetiapine fumarate

flexible dose oral

DRUGrisperidone

flexible dose oral

Sponsors

AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* Men and women age 18 to 65 * Both Eyes present with lenses intact (no previous cataract extractions) * Stable place of residency

Exclusion criteria

* History of corneal surgery * Legal blindness (defined as best corrected visual acuity of 20/200 or worse in one or both eyes * Previous participation in this study

Design outcomes

Primary

MeasureTime frameDescription
Presence of a Cortical (C) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the Lens Opacities Classification System II (LOCS II ) Grading ScaleRandomization to Month 24Presence of C type of cataractogenic potential event in participant was defined if any LOCS II grades of 2, 3, 4, 5 (with any grade of 0, trace,1 at randomization) assessed and agreed by 2 independent, treatment-masked ophthalmologists at any post-randomization assessment in one or both eyes. 0= no cataract; 5 is worst. There are no subscales. 0 is the best, 5 is the worst.
Presence of a Nuclear Opalescence (N) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading ScaleRandomization to Month 24Presence of N type of cataractogenic potential event in Participants was defined if any LOCS II grades of 2, 3, 4 (with grade at rand equals 0,1), or if the LOCS II grades of 3,or 4 (with grade at randomization=2) assessed and agreed by 2 independent, treatment-masked ophthalmologists at any post-randomization assessment in one or both eyes. 0 is the best, 4 is the worst.
Presence of a Posterior Subcapsular (P) Type Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading ScaleRandomization to Month 24Presence of P type of cataractogenic potential event in participant was defined if any LOCS II grades of 1, 2, 3 , 4 (with grade=0 at randomization) assessed and agreed by 2 independent, treatment-masked ophthalmologists at any post-randomization assessment in one or both eyes. 0 is the best, 4 is the worst.

Secondary

MeasureTime frameDescription
Change in the PANSS Psychopathology Subscale ScoreRandomization to Month 24PANSS psychopathology subscale score equals sum of the 16-items scores(range:16-112). Each item has ( 1-7 units),1= absent psychosis symptom, 7= extreme symptom degree.Change in PANSS psychopathology subscale:score at month 24 minus score at randomization. Alleviation of general psychopathology symptoms are indicated by a negative change score.
Change in the Clinical Global Impression - Severity of Illness (CGI-S) ScoreRandomization to Month 24CGI-S score is accessed on a seven-graded scale ranging from most extremely ill/ very much worse (7) to normal/very much improved (1) , 1 is best. Change : score at month 24 minus score at randomization.
Change in Health-related Quality of Life as Measured by Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q SF) Total ScoreRandomization to Month 24Q-LES-Q total score is the sum of the 16 times of Q-LES-Q SF(range:16-80).Each item has a 5 point satisfaction level scale:from 1=very poor(worst value) to 5=very good(best).Larger values indicate a higher perceived quality of life enjoyment and satisfaction.Change in Q-LES-Q total score:total score at month 24 minus total score at randomization
Change in Personal Evaluation of Transitions in Treatment (PETiT) Total ScoreRandomization to Month 24PETiT total score is the sum of the 30 items of PETiT questionnaire(range:0-60) on subjects perceived well-being, adherence, tolerability, satisfaction with treatment. Each item is rated by participant with a 3 point frequency scale:2=often, 1=sometimes, 0=never.Change in PETiT total score: total score at month 24 minus total score at randomization
Change in the Positive and Negative Syndrome Scale (PANSS) Total ScoreRandomization to Month 24PANSS total score equals sum of the 30-items scores (range: 30-210). Each item has ( 1-7 units), 1 indicates absent psychosis symptom, and 7 - extreme symptom degree. Change in PANSS total score : total score at month 24 minus total score at randomization.Alleviation of psychotic symptoms are indicated by a negative change in PANSS total score.
Change in Simpson-Angus Scale (SAS) Total ScoreRandomization to Month 24SAS total score is the sum of the 10 individual-item scores (range:0-40), with the score for each item ranging from 0 to 4, higher scores indicate greater severity of Parkinsonian symptoms. Change : total score at month 24 minus total score at randomization. Increase in Change of total score indicates an increase in extrapyramidal motor symptoms.
Change in Barnes Akathisia Rating Scale (BARS) Global ScoreRandomization to Month 24BARS global score is the 4th individual-item score on the BARS scale, the Global Assessment of Akathisia, with the score ranging from 0 (no evidence of akathisia) to 5 (severe akathisia). Change : score at month 24 minus score at randomization. Increase in Change of BARS global score indicates an increase in akathisia.
Change in Abnormal Involuntary Movement Scale (AIMS) Total ScoreRandomization to Month 24AIMS total score is the sum of the 10 individual-item scores(range:0-40), with the score for each item ranging from 0 to 4. Change : total score at month 24 minus total score at randomization. Increase in Change of total score indicates an increase in abnormal voluntary movements. The lower score means lower intensity of abnormal voluntary Movements. 0 is best, 4 is worst. Increase in Change of total score indicates an increase in abnormal voluntary Movements.
Number of Participants With Potential Extrapyramidal Symptoms (EPS)From start of the study treatment to last dose plus 30 daysNumber of participants with adverse events potentially associated with EPS collected by MedDRA Preferred Terms as akathisia, bradykinesia, drooling, dyskinesia, dystonia, extrapyramidal disorder, grimacing, muscle rigidity, parkinsonism, restlessness, tardive dyskinesia, tremor
Number of Relapses of Schizophrenia or Schizoaffective DisorderAt Month 24Relapse is defined as a hospital stay for psychiatric symptoms or a 2-point increase from baseline in the CGI severity score. CGI-S score ranges from 0-7 with 0 = Not Assessed, 1 = Normal, not at all and 7 = Among the most extremely ill subjects.
Change in the PANSS Positive Subscale ScoreRandomization to Month 24PANSS Positive subscale score equals sum of the 7-items scores(range:7-49). Each item has ( 1-7 units), 1 indicates absent psychosis symptom, and 7 - extreme symptom degree.
Change in the PANSS Negative Subscale ScoreRandomization to Month 24PANSS Negative subscale score equals sum of the 7-items scores(range:7-49). Each item has ( 1-7 units), 1 indicates absent psychosis symptom, and 7 - extreme symptom degree. Change in PANSS Negative subscale score:score at month 24 minus score at randomization. Alleviation of negative psychotic symptoms are indicated by a negative change score.

Countries

United States

Participant flow

Recruitment details

A 24-month, multi-center, evaluator masked (ophthalmologist), open-label, flexible-dose, parallel-group study, 82 sites recruited Sept 2003 through Oct 2008. In total 1099 participants were randomized by Interactive Voice Response System (IVRS). One excluded participant was randomized before the rand visit, and never returned to any study visits.

Pre-assignment details

Screening for eligibility and must be cross-tapered off of all previous antipsychotic medications

Participants by arm

ArmCount
Quetiapine Fumarate
Quetiapine fumarate - flexibly dosed (200 - 800 mg/day)
596
Risperidone
Risperidone - flexibly dosed (2 - 8 mg/day)
502
Total1,098

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event11982
Overall StudyLack of therapeutic response1611
Overall StudyLost to Follow-up9566
Overall StudyNone of those categories4236
Overall StudyProtocol Violation02
Overall StudyStudy-specific discontinuation criteria1817
Overall StudyWithdrawal by Subject118101

Baseline characteristics

CharacteristicQuetiapine FumarateRisperidoneTotal
Age, Customized
40 to 65 years
331 Participants279 Participants610 Participants
Age, Customized
< 40 years
265 Participants223 Participants488 Participants
Sex: Female, Male
Female
253 Participants199 Participants452 Participants
Sex: Female, Male
Male
343 Participants303 Participants646 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
476 / 596368 / 502
serious
Total, serious adverse events
151 / 596114 / 502

Outcome results

Primary

Presence of a Cortical (C) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the Lens Opacities Classification System II (LOCS II ) Grading Scale

Presence of C type of cataractogenic potential event in participant was defined if any LOCS II grades of 2, 3, 4, 5 (with any grade of 0, trace,1 at randomization) assessed and agreed by 2 independent, treatment-masked ophthalmologists at any post-randomization assessment in one or both eyes. 0= no cataract; 5 is worst. There are no subscales. 0 is the best, 5 is the worst.

Time frame: Randomization to Month 24

Population: The 2-year eye per protocol (E2PP) analysis included all randomized participants who met eye eligibility, had a valid baseline LOCS II evaluation, had reached the study endpoint of either a LOCS II identified cataractogenic potential event or dosed for 21 months without a LOCS II event, and had no major protocol deviations.

ArmMeasureValue (NUMBER)
Quetiapine FumaratePresence of a Cortical (C) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the Lens Opacities Classification System II (LOCS II ) Grading Scale2 Participants with C type event
RisperidonePresence of a Cortical (C) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the Lens Opacities Classification System II (LOCS II ) Grading Scale8 Participants with C type event
Primary

Presence of a Nuclear Opalescence (N) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading Scale

Presence of N type of cataractogenic potential event in Participants was defined if any LOCS II grades of 2, 3, 4 (with grade at rand equals 0,1), or if the LOCS II grades of 3,or 4 (with grade at randomization=2) assessed and agreed by 2 independent, treatment-masked ophthalmologists at any post-randomization assessment in one or both eyes. 0 is the best, 4 is the worst.

Time frame: Randomization to Month 24

Population: The 2-year eye per protocol (E2PP) analysis included all randomized participants who met eye eligibility, had a valid baseline LOCS II evaluation, had reached the study endpoint of either a LOCS II identified cataractogenic potential event or dosed for 21 months without a LOCS II event, and had no major protocol deviations.

ArmMeasureValue (NUMBER)
Quetiapine FumaratePresence of a Nuclear Opalescence (N) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading Scale0 Participants with N type event
RisperidonePresence of a Nuclear Opalescence (N) Type of Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading Scale2 Participants with N type event
Primary

Presence of a Posterior Subcapsular (P) Type Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading Scale

Presence of P type of cataractogenic potential event in participant was defined if any LOCS II grades of 1, 2, 3 , 4 (with grade=0 at randomization) assessed and agreed by 2 independent, treatment-masked ophthalmologists at any post-randomization assessment in one or both eyes. 0 is the best, 4 is the worst.

Time frame: Randomization to Month 24

Population: The 2-year eye per protocol (E2PP) analysis included all randomized participants who met eye eligibility, had a valid baseline LOCS II evaluation, had reached the study endpoint of either a LOCS II identified cataractogenic potential event or dosed for 21 months without a LOCS II event, and had no major protocol deviations.

ArmMeasureValue (NUMBER)
Quetiapine FumaratePresence of a Posterior Subcapsular (P) Type Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading Scale4 Participants with P type event
RisperidonePresence of a Posterior Subcapsular (P) Type Cataractogenic Potential Events in Participants as Assessed and Agreed by 2 Independent, Treatment-masked Ophthalmologists Using the LOCS II Grading Scale7 Participants with P type event
Secondary

Change in Abnormal Involuntary Movement Scale (AIMS) Total Score

AIMS total score is the sum of the 10 individual-item scores(range:0-40), with the score for each item ranging from 0 to 4. Change : total score at month 24 minus total score at randomization. Increase in Change of total score indicates an increase in abnormal voluntary movements. The lower score means lower intensity of abnormal voluntary Movements. 0 is best, 4 is worst. Increase in Change of total score indicates an increase in abnormal voluntary Movements.

Time frame: Randomization to Month 24

Population: The Safety analysis set included all randomized participants who received at least 1 dose of study medication

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in Abnormal Involuntary Movement Scale (AIMS) Total Score-0.2 units on scaleStandard Deviation 2.5
RisperidoneChange in Abnormal Involuntary Movement Scale (AIMS) Total Score0.1 units on scaleStandard Deviation 2.5
Secondary

Change in Barnes Akathisia Rating Scale (BARS) Global Score

BARS global score is the 4th individual-item score on the BARS scale, the Global Assessment of Akathisia, with the score ranging from 0 (no evidence of akathisia) to 5 (severe akathisia). Change : score at month 24 minus score at randomization. Increase in Change of BARS global score indicates an increase in akathisia.

Time frame: Randomization to Month 24

Population: The Safety analysis set included all randomized participants who received at least 1 dose of study medication

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in Barnes Akathisia Rating Scale (BARS) Global Score-0.1 units of scaleStandard Deviation 0.7
RisperidoneChange in Barnes Akathisia Rating Scale (BARS) Global Score0.1 units of scaleStandard Deviation 0.8
Secondary

Change in Health-related Quality of Life as Measured by Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q SF) Total Score

Q-LES-Q total score is the sum of the 16 times of Q-LES-Q SF(range:16-80).Each item has a 5 point satisfaction level scale:from 1=very poor(worst value) to 5=very good(best).Larger values indicate a higher perceived quality of life enjoyment and satisfaction.Change in Q-LES-Q total score:total score at month 24 minus total score at randomization

Time frame: Randomization to Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score, and received at least 1 dose of study medication.

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in Health-related Quality of Life as Measured by Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q SF) Total Score2.4 units on scaleStandard Deviation 11.6
RisperidoneChange in Health-related Quality of Life as Measured by Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q SF) Total Score2.7 units on scaleStandard Deviation 10.4
Secondary

Change in Personal Evaluation of Transitions in Treatment (PETiT) Total Score

PETiT total score is the sum of the 30 items of PETiT questionnaire(range:0-60) on subjects perceived well-being, adherence, tolerability, satisfaction with treatment. Each item is rated by participant with a 3 point frequency scale:2=often, 1=sometimes, 0=never.Change in PETiT total score: total score at month 24 minus total score at randomization

Time frame: Randomization to Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score, and received at least 1 dose of study medication.

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in Personal Evaluation of Transitions in Treatment (PETiT) Total Score1.2 units on scaleStandard Deviation 6.2
RisperidoneChange in Personal Evaluation of Transitions in Treatment (PETiT) Total Score0.9 units on scaleStandard Deviation 6
Secondary

Change in Simpson-Angus Scale (SAS) Total Score

SAS total score is the sum of the 10 individual-item scores (range:0-40), with the score for each item ranging from 0 to 4, higher scores indicate greater severity of Parkinsonian symptoms. Change : total score at month 24 minus total score at randomization. Increase in Change of total score indicates an increase in extrapyramidal motor symptoms.

Time frame: Randomization to Month 24

Population: The Safety analysis set included all randomized participants who received at least 1 dose of study medication

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in Simpson-Angus Scale (SAS) Total Score-0.7 units on scaleStandard Deviation 2.1
RisperidoneChange in Simpson-Angus Scale (SAS) Total Score-0.4 units on scaleStandard Deviation 2.8
Secondary

Change in the Clinical Global Impression - Severity of Illness (CGI-S) Score

CGI-S score is accessed on a seven-graded scale ranging from most extremely ill/ very much worse (7) to normal/very much improved (1) , 1 is best. Change : score at month 24 minus score at randomization.

Time frame: Randomization to Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score (not related to CGI-S), and received at least 1 dose of study medication.

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in the Clinical Global Impression - Severity of Illness (CGI-S) Score-0.7 units on scaleStandard Deviation 0.9
RisperidoneChange in the Clinical Global Impression - Severity of Illness (CGI-S) Score-0.5 units on scaleStandard Deviation 1
Secondary

Change in the PANSS Negative Subscale Score

PANSS Negative subscale score equals sum of the 7-items scores(range:7-49). Each item has ( 1-7 units), 1 indicates absent psychosis symptom, and 7 - extreme symptom degree. Change in PANSS Negative subscale score:score at month 24 minus score at randomization. Alleviation of negative psychotic symptoms are indicated by a negative change score.

Time frame: Randomization to Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score, and received at least 1 dose of study medication.

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in the PANSS Negative Subscale Score-2.2 units on scaleStandard Deviation 5.5
RisperidoneChange in the PANSS Negative Subscale Score-1.5 units on scaleStandard Deviation 5.7
Secondary

Change in the PANSS Positive Subscale Score

PANSS Positive subscale score equals sum of the 7-items scores(range:7-49). Each item has ( 1-7 units), 1 indicates absent psychosis symptom, and 7 - extreme symptom degree.

Time frame: Randomization to Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score, and received at least 1 dose of study medication.

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in the PANSS Positive Subscale Score-2.7 units on scaleStandard Deviation 5.3
RisperidoneChange in the PANSS Positive Subscale Score-2.8 units on scaleStandard Deviation 5.1
Secondary

Change in the PANSS Psychopathology Subscale Score

PANSS psychopathology subscale score equals sum of the 16-items scores(range:16-112). Each item has ( 1-7 units),1= absent psychosis symptom, 7= extreme symptom degree.Change in PANSS psychopathology subscale:score at month 24 minus score at randomization. Alleviation of general psychopathology symptoms are indicated by a negative change score.

Time frame: Randomization to Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score, and received at least 1 dose of study medication.

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in the PANSS Psychopathology Subscale Score-4.2 units on scaleStandard Deviation 7.7
RisperidoneChange in the PANSS Psychopathology Subscale Score-4.4 units on scaleStandard Deviation 8.8
Secondary

Change in the Positive and Negative Syndrome Scale (PANSS) Total Score

PANSS total score equals sum of the 30-items scores (range: 30-210). Each item has ( 1-7 units), 1 indicates absent psychosis symptom, and 7 - extreme symptom degree. Change in PANSS total score : total score at month 24 minus total score at randomization.Alleviation of psychotic symptoms are indicated by a negative change in PANSS total score.

Time frame: Randomization to Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score, and received at least 1 dose of study medication.

ArmMeasureValue (MEAN)Dispersion
Quetiapine FumarateChange in the Positive and Negative Syndrome Scale (PANSS) Total Score-9.1 units on scaleStandard Deviation 15.4
RisperidoneChange in the Positive and Negative Syndrome Scale (PANSS) Total Score-8.6 units on scaleStandard Deviation 16.6
Secondary

Number of Participants With Potential Extrapyramidal Symptoms (EPS)

Number of participants with adverse events potentially associated with EPS collected by MedDRA Preferred Terms as akathisia, bradykinesia, drooling, dyskinesia, dystonia, extrapyramidal disorder, grimacing, muscle rigidity, parkinsonism, restlessness, tardive dyskinesia, tremor

Time frame: From start of the study treatment to last dose plus 30 days

Population: The Safety analysis set included all randomized participants who received at least 1 dose of study medication

ArmMeasureValue (NUMBER)
Quetiapine FumarateNumber of Participants With Potential Extrapyramidal Symptoms (EPS)73 Participants
RisperidoneNumber of Participants With Potential Extrapyramidal Symptoms (EPS)106 Participants
Secondary

Number of Relapses of Schizophrenia or Schizoaffective Disorder

Relapse is defined as a hospital stay for psychiatric symptoms or a 2-point increase from baseline in the CGI severity score. CGI-S score ranges from 0-7 with 0 = Not Assessed, 1 = Normal, not at all and 7 = Among the most extremely ill subjects.

Time frame: At Month 24

Population: The intention-to-treat for psychiatric assessments (ITTP) analysis included all randomized participants who had a valid baseline and at least 1 post baseline assessment of PANSS total score, and received at least 1 dose of study medication.

ArmMeasureValue (NUMBER)
Quetiapine FumarateNumber of Relapses of Schizophrenia or Schizoaffective Disorder24 Relapses
RisperidoneNumber of Relapses of Schizophrenia or Schizoaffective Disorder33 Relapses

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026