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A Trial Comparing Risperidone Long-Acting Injection With Oral Antipsychotic in the Treatment of Early Psychosis

An Open-Label Randomized Trial Comparing Risperdal Consta With Oral Antipsychotic Care in the Treatment of Early Psychosis

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00246259
Enrollment
77
Registered
2005-10-31
Start date
2004-10-31
Completion date
2008-12-31
Last updated
2013-12-11

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

Conditions

Psychotic Disorders, Schizoaffective Disorder, Schizophrenia, Schizophreniform Disorder

Keywords

Schizophrenia, Schizoaffective disorder, Schizophreniform disorder, Risperidone, Risperdal Consta

Brief summary

The purpose of this study is to evaluate the effectiveness, safety and tolerability of risperidone long-acting injection (LAI) versus oral antipsychotics in participants with recent onset psychosis (abnormal thinking and/or hallucinations).

Detailed description

This is an open-label (all people know identity of intervention), randomized (the study drug is assigned by chance), multicenter (conducted in more than 1 center), and exploratory study in participants with schizophrenia (psychiatric disorder with symptoms of emotional instability, detachment from reality) or schizoaffective disorder (mixed psychiatric disorder relating to complex psychotic state that has features of both schizophrenia and mood disorder). Duration of this study will be 24 months. Study assessment visits will be conducted at Screening, Baseline, Week 2, every 4 weeks till Week 22, at Week 28, every 12 weeks till Week 88 and at Week 104. All eligible participants will receive either risperidone long acting injection 25 milligram (mg) intramuscularly (into the muscle) along with their current oral medication (atypical antipsychotic - risperidone, quetiapine, olanzapine) or only their current oral medication. Efficacy will be evaluated primarily by Positive and Negative Syndromes Scale (PANSS), time to relapse and Social and Occupational Functioning Assessment Scale (SOFAS). Participants's safety will be evaluated throughout the study mainly by Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), and Simpson Angus Scale (SAS).

Interventions

Risperidone LAI 25 mg, 37.5 mg or 50 mg intramuscular injection will be administered every 2 weeks as per Investigator's discretion.

DRUGOral Antipsychotic

Oral antipsychotic (new or current treatment) will be administered in which daily dose range permitted will be risperidone 6 mg; olanzapine 20 mg; quetiapine 800 mg.

Sponsors

Janssen-Ortho Inc., Canada
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
No

Inclusion criteria

* In-patients or out-patients * Primary Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of schizophrenia, schizophreniform disorder or schizoaffective disorder for no longer than 3 years after diagnosis and treatment of a psychotic illness * Positive and Negative Syndrome Scale (PANSS) score of 60-120 at Visit 1 and 2 * Currently on monotherapy atypical antipsychotic treatment below local label guidelines or treatment naive * Able to complete self-assessments in either English or French

Exclusion criteria

* Current primary Axis-1 diagnosis other than schizophrenia, schizophreniform disorder or schizoaffective disorder, according to DSM-IV * Current drug or alcohol dependence * Treatment with a depot antipsychotic within 3 months of study start * Confirmed or suspected history of lack of tolerability, hypersensitivity or allergy to risperidone * Risperidone non-responders (based on evidence of adequate trial of treatment)

Design outcomes

Primary

MeasureTime frameDescription
Time to RelapseWeek 10 (post-stability) up to Week 104 or LRVTime to relapse was calculated from the start of the maintenance phase to date of relapse according to Csernansky: Psychiatric hospitalization; increased level of psychiatric care from start of maintenance period and 25 percent increase in total PANSS score from first maintenance visit, or 10 points increase where PANSS at start of maintenance period was 40 or less; deliberate self-injury, suicidal or homicidal ideation; violent to others; property damage; or substantial clinical deterioration, defined as Clinical Global Impression of Change (CGI-C) score of 6 (much worse).
Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 104 or Last Reported Visit (LRV)Baseline, Week 104 or LRVThe PANSS provides a total score (sum of the scores of all 30 items) and scores for 3 subscales, the positive subscale (7 items), the negative subscale (7 items), and the general psychopathology subscale (16 items), each rated on a 7-point scale that ranges from 1 (absent) to 7 (extreme). The PANSS total score consists of the sum of all 30 PANSS items and ranges from 30 to 210. Higher scores indicate worsening.
Change From Baseline in Social and Occupational Functioning Assessment Scale (SOFAS) at Week 104 or LRVBaseline, Week 104 or LRVThe SOFAS focused exclusively on participants' level of social and occupational functioning. The SOFAS is a 100 point single item scale that rates functioning of a participant. The scale values range from 1=most impaired to 100=healthiest individual. The scale also includes a rating point of 0=missing information.

Secondary

MeasureTime frameDescription
Change From Baseline Hamilton Anxiety Scale (HAM-A) Total Score at Week 104 or LRVBaseline, Week 104 or LRVThe HAM-A is a 14-item scale designed to measure anxiety in individuals. Each question reflects a symptom of anxiety and physical as well as mental symptoms are represented. The answers range from 0 which signifies a complete lack of that symptom to 4, which indicates a very severe show of anxiety with that symptom. Total score ranges from 0 to 56. Lower score indicates less affected.
Percentage of Participants With RelapseWeek 10 (post-stability) up to Week 104 or LRVRelapse was defined according to Csernansky: Psychiatric hospitalization; increased level of psychiatric care from start of maintenance period and 25 percent increase in total PANSS score from first maintenance visit, or 10 points increase where PANSS at start of maintenance period was 40 or less; deliberate self-injury, suicidal or homicidal ideation; violent to others; property damage; or substantial clinical deterioration, defined as CGI-C score of 6 (much worse).
Number of Participants With Cognitive Assessments Using Trail BWeek -2, 104 or LRVCognitive assessments were done using Trail test B, which measured variety of functions, including motor speed, visual scanning, attention and visual motor integration. In Trail B, 2 sets of circles contain numbers and letters, and the participant must connect them in alternating order. Trail B is also a measure of executive functions as it requires planning and decision-making.
Total Words Score Over TimeBaseline, Week 104 or LRVControlled Word Association Test (COWAT) was used to assess verbal fluency. Participants are given 3 different letters of the alphabet and asked to say as many words beginning with each letter within a controlled time. Participants are then asked to identify as many words as possible in 3 different categories (animals, fruits and vegetables) within a specified period of time. The total score is a sum of all three categories scores. The total score ranges from 0-90, the higher the score the higher the verbal fluency.
Change From Baseline in Drug Attitude Inventory (DAI-10) Score at Week 104 or LRVUp to Week 104 or LRVThe DAI, a 10-item scale to assess how the attitude of schizophrenia participants toward their medications may affect compliance. Respondents indicate 'true' or 'false' for each item. An overall calculated score ranged from -10 to 10, where a positive score indicated a positive subjective response (compliant), a negative score indicated non-compliance. Change: score at observation minus score at baseline.
Change From Baseline in Standardized Mental Component Scale Score in Short Form 36 (SF-36) at Week 104 or LRVUp to Week 104 or LRVThe SF-36 is a survey of participant health. It calculates two standardized scales: the standardized mental component scale and the standardized physical component scale. The standardized scales are calculated as weighted sums of the 8 scores, which are: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health. Each item is scored on a 0-100 range; and standardized mental component scale score is calculated as weighted average of individual item scores on a 0-100 range, where 100 signify highest level of functioning. The change from baseline in mental component scale score was reported.
Number of Participants With Cognitive Assessment Using Trail AWeek -2, 104 or LRVCognitive assessments were done using Trail test A which measured variety of functions, including motor speed, visual scanning, attention and visual motor integration. Participants must connect numbered circles in a variety of orders.
Change From Baseline in Calgary Depression Symptom Scale (CDSS) Score at Week 104 or LRVBaseline, Week 104 or LRVCo-morbid depressive symptoms are evaluated by change in CDSS Score which was developed to assess symptoms of depression in participants with schizophrenia (psychiatric disorder with symptoms of emotional instability, detachment from reality, often with delusions and hallucinations, and withdrawal into the self). It consists of 9 items, each scored from 0 (absent) to 3 (severe). The total score is a sum of the scores of each item and may range from 0 to 27. Higher score more severe pathology. Data presented here represents the change from baseline to endpoint.
Change From Baseline in Young Mania Rating Scale (YMRS) at Week 104 or LRVBaseline, Week 104 or LRVCo-morbid symptoms of mania are evaluated by change in YMRS Score which is an 11-item scale to assess symptoms of mania, Four items are rated on a scale from 0 (symptom not present) to 8 (symptom extremely severe). The remaining items are rated on a scale from 0 (symptom not present) to 4 (symptom extremely severe). The YMRS total score ranges from 0 (the least) to 60 (the worst).

Other

MeasureTime frameDescription
Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline, Week 104 or LRVThe BARS evaluates akathisia (feeling of restlessness) associated with the use of antipsychotic medications, including an objective and a subjective component plus a global impression. Components are rated on a scale of 0 (normal or absence of restlessness)-3 (intense restlessness) and 0 (absent)-5 (severe akathisia) for the global clinical assessment. Number of participants in each global clinical assessment scale are reported.
Abnormal Involuntary Movement Scale (AIMS)Baseline, Week 104 or LRVThe AIMS is a 12-item scale to provide a numeric measure to the observed abnormal movements in different parts of the body. Information is collected after a brief neurological examination and is scored on a 5-point scale (0=none, 4=severe). Ten items are scored in a 5-point scale (0 = none/normal, 4 = severe) which evaluates abnormal movements in three main anatomic areas (orofacial area, extremities, and trunk). Two items are yes/no questions regarding dental status. Total scores range from 0 to 42 with higher values indicating more severity.
Simpson Angus Scale (SAS)Baseline, Week 104 or LRVThe SAS is a 10-item scale used to measure the symptoms of parkinsonism (slow movements) or parkinsonian side-effects related to the use of antipsychotic medications. The 10 items are rated on a 5-point scale (0=complete absence, 4=extreme presence) after a brief neurological examination and observation of the participants' gait (slow, shuffling walk). Total score is sum of individual item scores (range 0 to 40); higher score indicates more affected.

Countries

Canada

Participant flow

Participants by arm

ArmCount
Risperidone Long-acting Injection (LAI)
Risperidone LAI 25 mg, 37.5 mg or 50 mg intramuscular injection was administered every 2 weeks as per Investigator's discretion. An oral atypical antipsychotic was administered in the first 3 weeks following initiation of Risperidone LAI, and for a maximum of 3 weeks following a dose increase.
42
Oral Antipsychotic
Oral antipsychotic (new or current treatment) was administered in which daily dose range permitted was risperidone 6 mg; olanzapine 20 mg; quetiapine 800 mg. Participants switched to another oral therapy as per Investigator's discretion.
35
Total77

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event50
Overall StudyInvestigator withdrew participant20
Overall StudyLack of Efficacy22
Overall StudyLost to Follow-up34
Overall StudyNot stable by Week 1821
Overall StudyOther33
Overall StudyParticipant non-compliant49
Overall Studyrandomly assigned, not eligible for ITT26
Overall StudyWithdrawal by Subject51

Baseline characteristics

CharacteristicRisperidone Long-acting Injection (LAI)Oral AntipsychoticTotal
Age Continuous22.5 Years
STANDARD_DEVIATION 3.12
23.0 Years
STANDARD_DEVIATION 2.93
22.7 Years
STANDARD_DEVIATION 3.03
Sex: Female, Male
Female
9 Participants3 Participants12 Participants
Sex: Female, Male
Male
33 Participants32 Participants65 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
38 / 4434 / 41
serious
Total, serious adverse events
2 / 443 / 41

Outcome results

Primary

Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 104 or Last Reported Visit (LRV)

The PANSS provides a total score (sum of the scores of all 30 items) and scores for 3 subscales, the positive subscale (7 items), the negative subscale (7 items), and the general psychopathology subscale (16 items), each rated on a 7-point scale that ranges from 1 (absent) to 7 (extreme). The PANSS total score consists of the sum of all 30 PANSS items and ranges from 30 to 210. Higher scores indicate worsening.

Time frame: Baseline, Week 104 or LRV

Population: Intent-to-treat (ITT) analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. One participant was missing as reported in oral antipsychotic arm. 'n' = participants evaluable for this measure at given time points.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 104 or Last Reported Visit (LRV)Baseline (n=42, 35)80.6 Units on a scaleStandard Deviation 12.22
Risperidone Long-acting Injection (LAI)Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 104 or Last Reported Visit (LRV)Change at Week 104 or LRV (n=42, 34)-18.1 Units on a scaleStandard Deviation 22.48
Oral AntipsychoticChange From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 104 or Last Reported Visit (LRV)Baseline (n=42, 35)79.7 Units on a scaleStandard Deviation 12.47
Oral AntipsychoticChange From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 104 or Last Reported Visit (LRV)Change at Week 104 or LRV (n=42, 34)-17.7 Units on a scaleStandard Deviation 16.45
Primary

Change From Baseline in Social and Occupational Functioning Assessment Scale (SOFAS) at Week 104 or LRV

The SOFAS focused exclusively on participants' level of social and occupational functioning. The SOFAS is a 100 point single item scale that rates functioning of a participant. The scale values range from 1=most impaired to 100=healthiest individual. The scale also includes a rating point of 0=missing information.

Time frame: Baseline, Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'n' = participants evaluable for this measure at given time points.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Change From Baseline in Social and Occupational Functioning Assessment Scale (SOFAS) at Week 104 or LRVBaseline (n=42, 35)53.4 Units on a scaleStandard Deviation 11.23
Risperidone Long-acting Injection (LAI)Change From Baseline in Social and Occupational Functioning Assessment Scale (SOFAS) at Week 104 or LRVChange at Week 104 or LRV (n=34, 28)4.6 Units on a scaleStandard Deviation 16.82
Oral AntipsychoticChange From Baseline in Social and Occupational Functioning Assessment Scale (SOFAS) at Week 104 or LRVBaseline (n=42, 35)49.5 Units on a scaleStandard Deviation 12.93
Oral AntipsychoticChange From Baseline in Social and Occupational Functioning Assessment Scale (SOFAS) at Week 104 or LRVChange at Week 104 or LRV (n=34, 28)9.5 Units on a scaleStandard Deviation 15.24
Primary

Time to Relapse

Time to relapse was calculated from the start of the maintenance phase to date of relapse according to Csernansky: Psychiatric hospitalization; increased level of psychiatric care from start of maintenance period and 25 percent increase in total PANSS score from first maintenance visit, or 10 points increase where PANSS at start of maintenance period was 40 or less; deliberate self-injury, suicidal or homicidal ideation; violent to others; property damage; or substantial clinical deterioration, defined as Clinical Global Impression of Change (CGI-C) score of 6 (much worse).

Time frame: Week 10 (post-stability) up to Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment.

ArmMeasureValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Time to Relapse80.5 WeeksStandard Deviation 6.3
Oral AntipsychoticTime to Relapse79.5 WeeksStandard Deviation 4.1
Secondary

Change From Baseline Hamilton Anxiety Scale (HAM-A) Total Score at Week 104 or LRV

The HAM-A is a 14-item scale designed to measure anxiety in individuals. Each question reflects a symptom of anxiety and physical as well as mental symptoms are represented. The answers range from 0 which signifies a complete lack of that symptom to 4, which indicates a very severe show of anxiety with that symptom. Total score ranges from 0 to 56. Lower score indicates less affected.

Time frame: Baseline, Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'n' = participants evaluable for this measure at given time points.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Change From Baseline Hamilton Anxiety Scale (HAM-A) Total Score at Week 104 or LRVBaseline (n=42, 35)7.2 Units on a scaleStandard Deviation 5.94
Risperidone Long-acting Injection (LAI)Change From Baseline Hamilton Anxiety Scale (HAM-A) Total Score at Week 104 or LRVChange at Week 104 or LRV (n=34, 28)-0.8 Units on a scaleStandard Deviation 6.23
Oral AntipsychoticChange From Baseline Hamilton Anxiety Scale (HAM-A) Total Score at Week 104 or LRVBaseline (n=42, 35)7.3 Units on a scaleStandard Deviation 4.66
Oral AntipsychoticChange From Baseline Hamilton Anxiety Scale (HAM-A) Total Score at Week 104 or LRVChange at Week 104 or LRV (n=34, 28)-2.9 Units on a scaleStandard Deviation 4.98
Secondary

Change From Baseline in Calgary Depression Symptom Scale (CDSS) Score at Week 104 or LRV

Co-morbid depressive symptoms are evaluated by change in CDSS Score which was developed to assess symptoms of depression in participants with schizophrenia (psychiatric disorder with symptoms of emotional instability, detachment from reality, often with delusions and hallucinations, and withdrawal into the self). It consists of 9 items, each scored from 0 (absent) to 3 (severe). The total score is a sum of the scores of each item and may range from 0 to 27. Higher score more severe pathology. Data presented here represents the change from baseline to endpoint.

Time frame: Baseline, Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'n' = participants evaluable for this measure at given time points.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Change From Baseline in Calgary Depression Symptom Scale (CDSS) Score at Week 104 or LRVBaseline (n=42, 35)3.7 Units on a scaleStandard Deviation 3.44
Risperidone Long-acting Injection (LAI)Change From Baseline in Calgary Depression Symptom Scale (CDSS) Score at Week 104 or LRVChange at Week 104 or LRV (n=34, 28)0.1 Units on a scaleStandard Deviation 5.38
Oral AntipsychoticChange From Baseline in Calgary Depression Symptom Scale (CDSS) Score at Week 104 or LRVBaseline (n=42, 35)3.5 Units on a scaleStandard Deviation 2.8
Oral AntipsychoticChange From Baseline in Calgary Depression Symptom Scale (CDSS) Score at Week 104 or LRVChange at Week 104 or LRV (n=34, 28)-1.0 Units on a scaleStandard Deviation 3.12
Secondary

Change From Baseline in Drug Attitude Inventory (DAI-10) Score at Week 104 or LRV

The DAI, a 10-item scale to assess how the attitude of schizophrenia participants toward their medications may affect compliance. Respondents indicate 'true' or 'false' for each item. An overall calculated score ranged from -10 to 10, where a positive score indicated a positive subjective response (compliant), a negative score indicated non-compliance. Change: score at observation minus score at baseline.

Time frame: Up to Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'N' (number of participants analyzed) signifies those participants who were evaluable for this measure.

ArmMeasureValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Change From Baseline in Drug Attitude Inventory (DAI-10) Score at Week 104 or LRV-0.1 Units on a scaleStandard Deviation 2.08
Oral AntipsychoticChange From Baseline in Drug Attitude Inventory (DAI-10) Score at Week 104 or LRV-0.2 Units on a scaleStandard Deviation 2.71
Secondary

Change From Baseline in Standardized Mental Component Scale Score in Short Form 36 (SF-36) at Week 104 or LRV

The SF-36 is a survey of participant health. It calculates two standardized scales: the standardized mental component scale and the standardized physical component scale. The standardized scales are calculated as weighted sums of the 8 scores, which are: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health. Each item is scored on a 0-100 range; and standardized mental component scale score is calculated as weighted average of individual item scores on a 0-100 range, where 100 signify highest level of functioning. The change from baseline in mental component scale score was reported.

Time frame: Up to Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'N' (number of participants analyzed) signifies those participants who were evaluable for this measure.

ArmMeasureValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Change From Baseline in Standardized Mental Component Scale Score in Short Form 36 (SF-36) at Week 104 or LRV0.6 Units on a scaleStandard Deviation 14.95
Oral AntipsychoticChange From Baseline in Standardized Mental Component Scale Score in Short Form 36 (SF-36) at Week 104 or LRV4.7 Units on a scaleStandard Deviation 12.66
Secondary

Change From Baseline in Young Mania Rating Scale (YMRS) at Week 104 or LRV

Co-morbid symptoms of mania are evaluated by change in YMRS Score which is an 11-item scale to assess symptoms of mania, Four items are rated on a scale from 0 (symptom not present) to 8 (symptom extremely severe). The remaining items are rated on a scale from 0 (symptom not present) to 4 (symptom extremely severe). The YMRS total score ranges from 0 (the least) to 60 (the worst).

Time frame: Baseline, Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'n' = participants evaluable for this measure at given time points.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Change From Baseline in Young Mania Rating Scale (YMRS) at Week 104 or LRVBaseline (n=42,35)4.0 Units on a scaleStandard Deviation 4.02
Risperidone Long-acting Injection (LAI)Change From Baseline in Young Mania Rating Scale (YMRS) at Week 104 or LRVChange at Week 104 or LRV (n=34,28)-1.1 Units on a scaleStandard Deviation 4.35
Oral AntipsychoticChange From Baseline in Young Mania Rating Scale (YMRS) at Week 104 or LRVBaseline (n=42,35)4.3 Units on a scaleStandard Deviation 4.03
Oral AntipsychoticChange From Baseline in Young Mania Rating Scale (YMRS) at Week 104 or LRVChange at Week 104 or LRV (n=34,28)-1.5 Units on a scaleStandard Deviation 3.33
Secondary

Number of Participants With Cognitive Assessments Using Trail B

Cognitive assessments were done using Trail test B, which measured variety of functions, including motor speed, visual scanning, attention and visual motor integration. In Trail B, 2 sets of circles contain numbers and letters, and the participant must connect them in alternating order. Trail B is also a measure of executive functions as it requires planning and decision-making.

Time frame: Week -2, 104 or LRV

Population: The ITT population included all participants who received at least 3 doses of risperidone or 6 weeks of oral antipsychotic, and had at least 1 post-baseline efficacy assessment.

ArmMeasureGroupValue (NUMBER)
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek -2 (0-65 Seconds)17 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek -2 (66-85 seconds)8 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek -2 (86-120 seconds)8 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek -2 (121+ seconds)8 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek -2 (Not reported)1 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek 104 (0-65 seconds)17 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek 104 (66-85 seconds)7 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek 104 (86-120 seconds)4 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek 104 (121+ seconds)2 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessments Using Trail BWeek 104 (Not reported)12 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek 104 (86-120 seconds)5 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek -2 (0-65 Seconds)12 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek 104 (0-65 seconds)16 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek -2 (66-85 seconds)5 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek 104 (Not reported)7 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek -2 (86-120 seconds)3 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek 104 (66-85 seconds)4 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek -2 (121+ seconds)13 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek 104 (121+ seconds)3 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessments Using Trail BWeek -2 (Not reported)2 Participants
Secondary

Number of Participants With Cognitive Assessment Using Trail A

Cognitive assessments were done using Trail test A which measured variety of functions, including motor speed, visual scanning, attention and visual motor integration. Participants must connect numbered circles in a variety of orders.

Time frame: Week -2, 104 or LRV

Population: The ITT population included all participants who received at least 3 doses of risperidone or 6 weeks of oral antipsychotic, and had at least 1 post-baseline efficacy assessment.

ArmMeasureGroupValue (NUMBER)
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek -2 (40-51 seconds)6 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek 104 (0-26 seconds)15 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek -2 (27-39 seconds)16 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek 104 (27-39 seconds)9 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek -2 (52+ seconds)6 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek 104 (40-51 seconds)4 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek -2 (0-26 seconds)13 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek -2 (Not reported)1 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek 104 (Not reported)12 Participants
Risperidone Long-acting Injection (LAI)Number of Participants With Cognitive Assessment Using Trail AWeek 104 (52+ seconds)2 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek 104 (Not reported)7 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek -2 (0-26 seconds)14 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek -2 (27-39 seconds)9 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek -2 (40-51 seconds)4 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek -2 (52+ seconds)6 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek -2 (Not reported)2 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek 104 (0-26 seconds)16 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek 104 (27-39 seconds)7 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek 104 (40-51 seconds)3 Participants
Oral AntipsychoticNumber of Participants With Cognitive Assessment Using Trail AWeek 104 (52+ seconds)2 Participants
Secondary

Percentage of Participants With Relapse

Relapse was defined according to Csernansky: Psychiatric hospitalization; increased level of psychiatric care from start of maintenance period and 25 percent increase in total PANSS score from first maintenance visit, or 10 points increase where PANSS at start of maintenance period was 40 or less; deliberate self-injury, suicidal or homicidal ideation; violent to others; property damage; or substantial clinical deterioration, defined as CGI-C score of 6 (much worse).

Time frame: Week 10 (post-stability) up to Week 104 or LRV

Population: The ITT analysis population included all the participants who received at least 3 doses of risperidone or 6 weeks of their oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'N' (number of participants analyzed) = participants evaluable for this measure.

ArmMeasureValue (NUMBER)
Risperidone Long-acting Injection (LAI)Percentage of Participants With Relapse34.4 Percentage of participants
Oral AntipsychoticPercentage of Participants With Relapse16.1 Percentage of participants
Secondary

Total Words Score Over Time

Controlled Word Association Test (COWAT) was used to assess verbal fluency. Participants are given 3 different letters of the alphabet and asked to say as many words beginning with each letter within a controlled time. Participants are then asked to identify as many words as possible in 3 different categories (animals, fruits and vegetables) within a specified period of time. The total score is a sum of all three categories scores. The total score ranges from 0-90, the higher the score the higher the verbal fluency.

Time frame: Baseline, Week 104 or LRV

Population: The ITT population:all participants who received at least 3 doses of risperidone or 6 weeks of oral antipsychotic, and had at least 1 post-baseline efficacy assessment. Here 'N' signifies participants evaluable for this measure and 'n' signifies participants evaluable at each time point for each treatment arm, respectively.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Total Words Score Over TimeBaseline (n=40, 31)62.4 Units on a scaleStandard Deviation 19.06
Risperidone Long-acting Injection (LAI)Total Words Score Over TimeWeek 104 or LRV (n=30, 28)63.1 Units on a scaleStandard Deviation 17.81
Oral AntipsychoticTotal Words Score Over TimeBaseline (n=40, 31)59.9 Units on a scaleStandard Deviation 16.49
Oral AntipsychoticTotal Words Score Over TimeWeek 104 or LRV (n=30, 28)65.4 Units on a scaleStandard Deviation 18.5
Other Pre-specified

Abnormal Involuntary Movement Scale (AIMS)

The AIMS is a 12-item scale to provide a numeric measure to the observed abnormal movements in different parts of the body. Information is collected after a brief neurological examination and is scored on a 5-point scale (0=none, 4=severe). Ten items are scored in a 5-point scale (0 = none/normal, 4 = severe) which evaluates abnormal movements in three main anatomic areas (orofacial area, extremities, and trunk). Two items are yes/no questions regarding dental status. Total scores range from 0 to 42 with higher values indicating more severity.

Time frame: Baseline, Week 104 or LRV

Population: Analysis population included all randomly assigned participants. Here 'n' signifies participants evaluable at each time point for each treatment arm, respectively.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Abnormal Involuntary Movement Scale (AIMS)Baseline (n=42,35)1.1 Units on a scaleStandard Deviation 2.07
Risperidone Long-acting Injection (LAI)Abnormal Involuntary Movement Scale (AIMS)Week 104 (n=35,29)0.7 Units on a scaleStandard Deviation 1.66
Oral AntipsychoticAbnormal Involuntary Movement Scale (AIMS)Baseline (n=42,35)0.8 Units on a scaleStandard Deviation 1.35
Oral AntipsychoticAbnormal Involuntary Movement Scale (AIMS)Week 104 (n=35,29)0.7 Units on a scaleStandard Deviation 1.37
Other Pre-specified

Barnes Akathisia Rating Scale (BARS) Global Clinical Assessment

The BARS evaluates akathisia (feeling of restlessness) associated with the use of antipsychotic medications, including an objective and a subjective component plus a global impression. Components are rated on a scale of 0 (normal or absence of restlessness)-3 (intense restlessness) and 0 (absent)-5 (severe akathisia) for the global clinical assessment. Number of participants in each global clinical assessment scale are reported.

Time frame: Baseline, Week 104 or LRV

Population: Analysis population included all randomly assigned participants. Here 'n' signifies participants evaluable at each time point for each treatment arm, respectively.

ArmMeasureGroupValue (NUMBER)
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Absent (n=42,35)29 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Questionable (n=42,35)11 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Mild Akathisia (n=42,35)2 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Moderate Akathisia (n=42,35)0 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Marked Akathisia (n=42,35)0 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Absent (n=35,29)21 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Questionable (n=35,29)7 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Mild Akathisia (n=35,29)6 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Moderate Akathisia (n=35,29)1 Participants
Risperidone Long-acting Injection (LAI)Barnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Marked Akathisia (n=35,29)0 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Mild Akathisia (n=35,29)2 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Absent (n=42,35)21 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Absent (n=35,29)25 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Questionable (n=42,35)8 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Marked Akathisia (n=35,29)0 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Mild Akathisia (n=42,35)6 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Questionable (n=35,29)2 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Moderate Akathisia (n=42,35)0 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentWeek 104: Moderate Akathisia (n=35,29)0 Participants
Oral AntipsychoticBarnes Akathisia Rating Scale (BARS) Global Clinical AssessmentBaseline: Marked Akathisia (n=42,35)0 Participants
Other Pre-specified

Simpson Angus Scale (SAS)

The SAS is a 10-item scale used to measure the symptoms of parkinsonism (slow movements) or parkinsonian side-effects related to the use of antipsychotic medications. The 10 items are rated on a 5-point scale (0=complete absence, 4=extreme presence) after a brief neurological examination and observation of the participants' gait (slow, shuffling walk). Total score is sum of individual item scores (range 0 to 40); higher score indicates more affected.

Time frame: Baseline, Week 104 or LRV

Population: Analysis population included all randomly assigned participants. Here 'N' (Number of Participants Analyzed) signifies participants who were evaluable for this measure and 'n' signifies participants evaluable at each time point for each treatment arm, respectively.

ArmMeasureGroupValue (MEAN)Dispersion
Risperidone Long-acting Injection (LAI)Simpson Angus Scale (SAS)Baseline (n=42,34)1.1 Units on a scaleStandard Deviation 1.9
Risperidone Long-acting Injection (LAI)Simpson Angus Scale (SAS)Week 104 (n=34,29)1.0 Units on a scaleStandard Deviation 1.77
Oral AntipsychoticSimpson Angus Scale (SAS)Baseline (n=42,34)1.2 Units on a scaleStandard Deviation 1.61
Oral AntipsychoticSimpson Angus Scale (SAS)Week 104 (n=34,29)1.0 Units on a scaleStandard Deviation 2.1

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