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Study Evaluating Cariprazine (RGH-188) in the Treatment of Patients With Acute Mania

A Double-Blind, Placebo-Controlled Evaluation of the Safety and Efficacy of RGH-188 in Patients With Acute Mania Associated With Bipolar I Disorder

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00488618
Enrollment
238
Registered
2007-06-20
Start date
2007-06-30
Completion date
2008-07-31
Last updated
2017-04-14

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

Conditions

Bipolar Disorder

Keywords

Mania, Bipolar I Disorder, Acute Mania Associated with Bipolar I Disorder

Brief summary

This is a study designed to evaluate the efficacy, safety, and tolerability of RGH-188 monotherapy in the treatment of acute mania. This study will be 5 weeks in duration; 3 weeks double-blind treatment and 2-weeks safety follow-up. All patients meeting the eligibility criteria will be randomized to one of two treatment groups: RGH-188 or placebo

Interventions

DRUGCariprazine (RGH-188)

Cariprazine 3 mg - 12 mg oral administration, once per day.

DRUGPlacebo

Dose-matched placebo oral administration, once per day.

Sponsors

Gedeon Richter Ltd.
CollaboratorINDUSTRY
Forest Laboratories
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

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

Inclusion criteria

* Male or female inpatients 18 to 65 years of age * Meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV) criteria for bipolar I disorder, acute manic or mixed episode * Having a total Young Mania Rating Scale (YMRS) score \>= 20 and a score of at least 4 on two of the following YMRS items: * Irritability, * Speech, * Content, and * Disruptive/Aggressive Behavior

Exclusion criteria

* Patients who exhibit abnormalities on physical examination, have abnormal vital-signs, electrocardiogram (ECG), or clinical laboratory values \[such as thyroid-stimulating hormone (TSH)\]. * Patients with Montgomery-Åsberg Depression Rating Scale (MADRS) total score \>= 18 at Visit 2. * Patients experiencing first manic episode. * Patients that have received electroconvulsive therapy (ECT) or a depot neuroleptic in the 3 months prior to Visit 1.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in the Young Mania Rating Scale (YMRS) Total Score at Week 3Baseline, Week 3The YMRS is an 11-item scale that assesses manic symptoms based on the participant's perception of his or her condition over the previous 48 hours, as well as the physician's clinical observations during the interview. The 11-items are elevated mood, increased motor activity-energy, sexual interest, sleep, irritability, rate and amount of speech, language-thought disorder, content, disruptive-aggressive behavior, appearance, and insight. The severity of the abnormality for 7-items are rated on a five-point scale (0-4) and 4-items on a nine-point scale (0-8). The individual scores are summed for a total possible score of 0 (best) to 60 (worst). A negative change from Baseline indicates improvement. Analyses are based on an Analysis of Covariance (ANCOVA) model for change from Baseline with treatment group and study center as factors and Baseline value as covariate.

Secondary

MeasureTime frameDescription
Change From Baseline in Clinical Global Impression-Severity (CGI-S) Total Score at Week 3Baseline, 3 WeeksThe CGI-S measures the investigator's assessment of overall severity of the participant's illness compared with the severity of illness in other patients the physician has observed using a 7-point scale (1=Normal, not ill at all to 7=Among the most extremely ill participants). A negative change from Baseline indicates improvement. Analyses are based on ANCOVA model for change from Baseline with treatment group and study center as factors and Baseline CGI-S score as covariate.

Countries

United States

Participant flow

Participants by arm

ArmCount
Placebo
Placebo dose-matching cariprazine capsules oral administration, once per day for 3 weeks.
118
Cariprazine
Cariprazine 3 mg - 12 mg capsules oral administration, once per day for 3 weeks.
118
Total236

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event1317
Overall StudyInsufficient Therapeutic Response1811
Overall StudyLost to Follow-up10
Overall StudyProtocol Violation02
Overall StudyWithdrawal of Consent1513

Baseline characteristics

CharacteristicPlaceboCariprazineTotal
Age, Continuous38.7 years
STANDARD_DEVIATION 11
38.0 years
STANDARD_DEVIATION 10.3
38.3 years
STANDARD_DEVIATION 10.7
Body Mass Index (BMI)27.2 kg/meter(m)^2
STANDARD_DEVIATION 5.8
25.8 kg/meter(m)^2
STANDARD_DEVIATION 5.9
26.5 kg/meter(m)^2
STANDARD_DEVIATION 5.9
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants6 Participants10 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
114 Participants112 Participants226 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Height170.0 centimeter (cm)
STANDARD_DEVIATION 10.4
169.9 centimeter (cm)
STANDARD_DEVIATION 10
170.0 centimeter (cm)
STANDARD_DEVIATION 10.2
Race/Ethnicity, Customized
Asian
28 Participants30 Participants58 Participants
Race/Ethnicity, Customized
Black
31 Participants36 Participants67 Participants
Race/Ethnicity, Customized
Caucasian
55 Participants47 Participants102 Participants
Race/Ethnicity, Customized
Other
4 Participants5 Participants9 Participants
Sex: Female, Male
Female
41 Participants38 Participants79 Participants
Sex: Female, Male
Male
77 Participants80 Participants157 Participants
Weight79.3 kilogram (kg)
STANDARD_DEVIATION 20
75.0 kilogram (kg)
STANDARD_DEVIATION 20.3
77.2 kilogram (kg)
STANDARD_DEVIATION 20.2

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
73 / 11890 / 118
serious
Total, serious adverse events
6 / 1187 / 118

Outcome results

Primary

Change From Baseline in the Young Mania Rating Scale (YMRS) Total Score at Week 3

The YMRS is an 11-item scale that assesses manic symptoms based on the participant's perception of his or her condition over the previous 48 hours, as well as the physician's clinical observations during the interview. The 11-items are elevated mood, increased motor activity-energy, sexual interest, sleep, irritability, rate and amount of speech, language-thought disorder, content, disruptive-aggressive behavior, appearance, and insight. The severity of the abnormality for 7-items are rated on a five-point scale (0-4) and 4-items on a nine-point scale (0-8). The individual scores are summed for a total possible score of 0 (best) to 60 (worst). A negative change from Baseline indicates improvement. Analyses are based on an Analysis of Covariance (ANCOVA) model for change from Baseline with treatment group and study center as factors and Baseline value as covariate.

Time frame: Baseline, Week 3

Population: Intent-to-treat Population included Participants who received at least 1 dose of study drug and who had at least 1 post-baseline YMRS assessment, last observation carried forward (LOCF).

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in the Young Mania Rating Scale (YMRS) Total Score at Week 3-8.91 score on a scaleStandard Error 1.083
CariprazineChange From Baseline in the Young Mania Rating Scale (YMRS) Total Score at Week 3-15.02 score on a scaleStandard Error 1.078
p-value: <0.000195% CI: [-8.9, -3.3]ANCOVA
Secondary

Change From Baseline in Clinical Global Impression-Severity (CGI-S) Total Score at Week 3

The CGI-S measures the investigator's assessment of overall severity of the participant's illness compared with the severity of illness in other patients the physician has observed using a 7-point scale (1=Normal, not ill at all to 7=Among the most extremely ill participants). A negative change from Baseline indicates improvement. Analyses are based on ANCOVA model for change from Baseline with treatment group and study center as factors and Baseline CGI-S score as covariate.

Time frame: Baseline, 3 Weeks

Population: Intent-to-treat Population included all participants who received at least 1 dose of study drug and who had at least 1 post-baseline YMRS assessment, LOCF.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Clinical Global Impression-Severity (CGI-S) Total Score at Week 3-0.93 score on a scaleStandard Error 0.125
CariprazineChange From Baseline in Clinical Global Impression-Severity (CGI-S) Total Score at Week 3-1.57 score on a scaleStandard Error 0.125
p-value: 0.000195% CI: [-0.97, -0.32]ANCOVA

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026