Skip to content

Efficacy and Safety of SEROQUEL Extended Release (XR) in Acute Schizophrenia

A 3 Weeks Open Label Study to Evaluate the Efficacy in Agitation and Safety of Quetiapine Fumarate XR in Treatment of Patients With Acute Schizophrenia

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00954122
Enrollment
35
Registered
2009-08-07
Start date
2009-09-30
Completion date
2010-04-30
Last updated
2013-01-08

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

Conditions

Schizophrenia

Keywords

Acute schizophrenia

Brief summary

The purpose of the study is to determine whether treatment with quetiapine XR (Seroquel XR) tablets for 3 weeks will improve their agitation when they have acute psychosis.

Interventions

DRUGQuetiapine XR (Seroquel XR)

Tablet, oral, once daily

Sponsors

AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Requirement for treatment of acute episode of schizophrenia (according to DSM-IV diagnostic criteria) * PANSS total score of ³ 75 * CGI \> 4

Exclusion criteria

* Any DSM-IV (Diagnostic and Statistical Manual of Mental Disorders 4th Edition) Axis I disorder not defined in the inclusion criteria * Patients who, in the opinion of the investigator, pose an imminent risk of suicide or a danger to self or others * Substance or alcohol dependence at enrollment

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Positive and Negative Syndrome Scale Excited Component (PANSS-EC) ScoreBaseline and Day 21PANSS- Excited Component (EC) subscale score will be calculated by adding together the following item scores: excitement (positive subscale item 4); hostility (positive subscale item 7); tension (general subscale item 4); uncooperativeness (general subscale item 8); poor impulse control (general subscale item 14). This is rated on a 7-point Likert scale from 'absent' to 'extremely severe' (score range 5 to 35 points; mean scores = 20 points clinically corresponds to severe agitation). Lower value gives the better outcome.

Secondary

MeasureTime frameDescription
Change From Baseline to Final Visit at Day 21 in PANSS Negative, General Psychopathological ScoresBaseline and Day 21Negative scale includes 7 items (Blunted affect, Emotional withdrawal, Poor rapport, Passive/apathetic social withdrawal, Difficulty in abstract thinking, Lack of spontaneity and flow of conversation, Stereotyped thinking)and is calculated by adding the negative subscale item scores. Minimum score is 7, maximum score is 49. General Psychopathology scale includes 16 Items (Somatic concern, Anxiety, Guilt feelings, Tension, Mannerisms and posturing, Depression, Motor retardation, Uncooperativeness, Unusual thought content, Disorientation, Poor attention, Lack of judgment and insight, Disturbance of volition, Poor impulse control, Preoccupation, Active social avoidance). Minimum score is 16, maximum score is 112. The higher score- the worse outcome. Measure includes PANSS-Negative (range 8-37), PANSS-General Psychopathological (PANSS-G)(range 17-70), total PANSS score (range 37-143), PANSS aggression, hostility and depression cluster scores (range 4-19).
Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total ScoreBaseline and Day 21Positive and Negative Syndrome Scale (PANSS) total score is a medical scale used for measuring symptom severity of patients with schizophrenia. It is calculated by adding together PANSS-Positive (minimum score = 7, maximum score = 49, PANSS-Negative (minimum score = 7, maximum score = 49), PANSS-General Psychopathological (PANSS-G) subscale scores (minimum score = 16, maximum score = 112), supplementary subscale item scores. The minimum is 30, maximum is 210. Total PANSS score classification: Mildly ill 58- 74, Moderately ill 75-94, Markly ill 95- 115, Severely ill \>116.
Change From Baseline to Final Visit at Day 21 in PANSS Positive, General Psychopathological Scores.Baseline and Day 21Positive scale includes 7 Items (Delusions, Conceptual disorganization, Hallucinations, Hyperactivity, Grandiosity, Suspiciousness/persecution, Hostility)and is calculated by adding the positive subscale item scores. Minimum score is 7, maximum score is 49. General Psychopathology scale:16 items (Somatic concern, Anxiety, Guilt feelings, Tension, Mannerisms and posturing, Depression, Motor retardation, Uncooperativeness, Unusual thought content, Disorientation, Poor attention, Lack of judgment and insight, Disturbance of volition, Poor impulse control, Preoccupation, Active social avoidance). Minimum score is 16, maximum score is 112. The higher score- the worse outcome. The biggest reduction of score from baseline- a better efficacy. Measure includes PANSS-Positive (range 8-30), PANSS-General Psychopathological (PANSS-G)(range 17-70), total PANSS score (range 37-143), PANSS aggression, hostility and depression cluster scores (range 4-19).
Change From Baseline in Absolute Clinical Global Impression-Improvement (CGI-I) ScaleBaseline and Day 21Clinical Global Impression, Improvement (CGI-I) is a single-item (7-point) scale that evaluates the overall improvement in the subject's mental. A reduction in score indicates an improvement in the subject's condition. This assessment is based on the improvement since initiation of the study treatment. Change in CGI-I score is analyzed by comparing CSI-score at the relevant time point to the baseline CGI-I score.
Change of the Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score Compared From Baseline to Day 21.Baseline and Day 21Excited Component was used to evaluate the control of agitation and aggression in patients with schizophrenia. Difference in mean score at baseline and day 21 is used to assess the improvement. It is shown by reduction in mean score and confirmed by p value lower than 0,05. Positive and Negative Syndrome Scale Excited Component (PANSS-EC) is a subscale score which is calculated by adding together the following item scores: excitement (positive subscale item 4); hostility (positive subscale item 7); tension (general subscale item 4); uncooperativeness (general subscale item 8); poor impulse control (general subscale item 14). This is rated on a 7-point Likert scale from 'absent' to 'extremely severe' (score range 5 to 35 points; mean scores = 20 points clinically corresponds to severe agitation).
Change From Baseline in Clinical Global Impression-Severity Scale (CGI-S)Baseline and Day 21Clinical Global Impression, Severity (CGI-S) is a single-item (7-point) scale that evaluates the overall severity of the subject's mental illness. A reduction in score indicates an improvement in the subject's condition. The CGI-S assessment should be based upon the subject's symptoms during the previous week. Change from baseline in CGI-S score is calculated by subtracting the CGI-S score at baseline from the CGI-S score at the relevant time point.

Countries

Malaysia

Participant flow

Recruitment details

18 Years to 65 Years Male & Female Acte schizophrenia (DSM-IV) Positive and Negative Syndrome Scale (PANSS) score at least 75, Clinical Global Impression (CGI)

Pre-assignment details

40 patients enrolled, 35 patients randomised and 28 patients completed the study

Participants by arm

ArmCount
Quetiapine Fumarate XR
This is a one arm Study. Patients were on quetiapine XR 300 mg on day 1, 600 mg on day 2, and 400-800 mg (at investigator's discretion) on day 3 and onwards
35
Total35

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event1
Overall StudySafety Reason1
Overall StudyWithdrawal by Subject5

Baseline characteristics

CharacteristicQuetiapine Fumarate XR
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
35 Participants
Age Continuous38.3 years
STANDARD_DEVIATION 11
Region of Enrollment
Malaysia
35 participants
Sex: Female, Male
Female
11 Participants
Sex: Female, Male
Male
24 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
0 / 35
serious
Total, serious adverse events
1 / 35

Outcome results

Primary

Change From Baseline in Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score

PANSS- Excited Component (EC) subscale score will be calculated by adding together the following item scores: excitement (positive subscale item 4); hostility (positive subscale item 7); tension (general subscale item 4); uncooperativeness (general subscale item 8); poor impulse control (general subscale item 14). This is rated on a 7-point Likert scale from 'absent' to 'extremely severe' (score range 5 to 35 points; mean scores = 20 points clinically corresponds to severe agitation). Lower value gives the better outcome.

Time frame: Baseline and Day 21

Population: ITT population, which comprise of patients who have baseline and at least ONE (1) set of post-baseline PANSS assessments. No imputation on PANSS-EC score.

ArmMeasureValue (MEAN)Dispersion
Quetiapine Fumarate XRChange From Baseline in Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score-7.5 Scores on a scaleStandard Deviation 4
Secondary

Change From Baseline in Absolute Clinical Global Impression-Improvement (CGI-I) Scale

Clinical Global Impression, Improvement (CGI-I) is a single-item (7-point) scale that evaluates the overall improvement in the subject's mental. A reduction in score indicates an improvement in the subject's condition. This assessment is based on the improvement since initiation of the study treatment. Change in CGI-I score is analyzed by comparing CSI-score at the relevant time point to the baseline CGI-I score.

Time frame: Baseline and Day 21

Population: ITT population, which comprise of patients who have baseline and at least ONE (1) set of post-baseline PANSS (Positive and Negative Syndrome Scale) assessments. No imputation on CGI-I score.

ArmMeasureGroupValue (MEAN)Dispersion
Quetiapine Fumarate XRChange From Baseline in Absolute Clinical Global Impression-Improvement (CGI-I) ScaleBaseline3.9 Scores on a scaleStandard Deviation 0.4
Quetiapine Fumarate XRChange From Baseline in Absolute Clinical Global Impression-Improvement (CGI-I) ScaleDay 212.4 Scores on a scaleStandard Deviation 1.2
Secondary

Change From Baseline in Clinical Global Impression-Severity Scale (CGI-S)

Clinical Global Impression, Severity (CGI-S) is a single-item (7-point) scale that evaluates the overall severity of the subject's mental illness. A reduction in score indicates an improvement in the subject's condition. The CGI-S assessment should be based upon the subject's symptoms during the previous week. Change from baseline in CGI-S score is calculated by subtracting the CGI-S score at baseline from the CGI-S score at the relevant time point.

Time frame: Baseline and Day 21

Population: ITT population, which comprise of patients who have baseline and at least ONE (1) set of post-baseline PANSS (Positive and Negative Syndrome Scale) assessments. No imputation on CGI-S score.

ArmMeasureValue (MEAN)Dispersion
Quetiapine Fumarate XRChange From Baseline in Clinical Global Impression-Severity Scale (CGI-S)-1.2 scores on a scaleStandard Deviation 0.9
Secondary

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

Positive and Negative Syndrome Scale (PANSS) total score is a medical scale used for measuring symptom severity of patients with schizophrenia. It is calculated by adding together PANSS-Positive (minimum score = 7, maximum score = 49, PANSS-Negative (minimum score = 7, maximum score = 49), PANSS-General Psychopathological (PANSS-G) subscale scores (minimum score = 16, maximum score = 112), supplementary subscale item scores. The minimum is 30, maximum is 210. Total PANSS score classification: Mildly ill 58- 74, Moderately ill 75-94, Markly ill 95- 115, Severely ill \>116.

Time frame: Baseline and Day 21

Population: ITT population, which comprise of patients who have baseline and at least ONE (1) set of post-baseline PANSS assessments. No imputation on PANSS Total score.

ArmMeasureValue (MEAN)Dispersion
Quetiapine Fumarate XRChange From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score-33.2 Scores on a scaleStandard Deviation 21.3
Secondary

Change From Baseline to Final Visit at Day 21 in PANSS Negative, General Psychopathological Scores

Negative scale includes 7 items (Blunted affect, Emotional withdrawal, Poor rapport, Passive/apathetic social withdrawal, Difficulty in abstract thinking, Lack of spontaneity and flow of conversation, Stereotyped thinking)and is calculated by adding the negative subscale item scores. Minimum score is 7, maximum score is 49. General Psychopathology scale includes 16 Items (Somatic concern, Anxiety, Guilt feelings, Tension, Mannerisms and posturing, Depression, Motor retardation, Uncooperativeness, Unusual thought content, Disorientation, Poor attention, Lack of judgment and insight, Disturbance of volition, Poor impulse control, Preoccupation, Active social avoidance). Minimum score is 16, maximum score is 112. The higher score- the worse outcome. Measure includes PANSS-Negative (range 8-37), PANSS-General Psychopathological (PANSS-G)(range 17-70), total PANSS score (range 37-143), PANSS aggression, hostility and depression cluster scores (range 4-19).

Time frame: Baseline and Day 21

Population: ITT population, which comprise of patients who have baseline and at least ONE (1) set of post-baseline PANSS assessments. No imputation on PANSS Positive score.

ArmMeasureValue (MEAN)Dispersion
Quetiapine Fumarate XRChange From Baseline to Final Visit at Day 21 in PANSS Negative, General Psychopathological Scores-5.7 Scores on a scaleStandard Deviation 4.9
Secondary

Change From Baseline to Final Visit at Day 21 in PANSS Positive, General Psychopathological Scores.

Positive scale includes 7 Items (Delusions, Conceptual disorganization, Hallucinations, Hyperactivity, Grandiosity, Suspiciousness/persecution, Hostility)and is calculated by adding the positive subscale item scores. Minimum score is 7, maximum score is 49. General Psychopathology scale:16 items (Somatic concern, Anxiety, Guilt feelings, Tension, Mannerisms and posturing, Depression, Motor retardation, Uncooperativeness, Unusual thought content, Disorientation, Poor attention, Lack of judgment and insight, Disturbance of volition, Poor impulse control, Preoccupation, Active social avoidance). Minimum score is 16, maximum score is 112. The higher score- the worse outcome. The biggest reduction of score from baseline- a better efficacy. Measure includes PANSS-Positive (range 8-30), PANSS-General Psychopathological (PANSS-G)(range 17-70), total PANSS score (range 37-143), PANSS aggression, hostility and depression cluster scores (range 4-19).

Time frame: Baseline and Day 21

Population: ITT population, which comprise of patients who have baseline and at least ONE (1) set of post-baseline PANSS assessments. No imputation on PANSS Negative score.

ArmMeasureValue (MEAN)Dispersion
Quetiapine Fumarate XRChange From Baseline to Final Visit at Day 21 in PANSS Positive, General Psychopathological Scores.-9.3 Scores on a scaleStandard Deviation 5.5
Secondary

Change of the Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score Compared From Baseline to Day 21.

Excited Component was used to evaluate the control of agitation and aggression in patients with schizophrenia. Difference in mean score at baseline and day 21 is used to assess the improvement. It is shown by reduction in mean score and confirmed by p value lower than 0,05. Positive and Negative Syndrome Scale Excited Component (PANSS-EC) is a subscale score which is calculated by adding together the following item scores: excitement (positive subscale item 4); hostility (positive subscale item 7); tension (general subscale item 4); uncooperativeness (general subscale item 8); poor impulse control (general subscale item 14). This is rated on a 7-point Likert scale from 'absent' to 'extremely severe' (score range 5 to 35 points; mean scores = 20 points clinically corresponds to severe agitation).

Time frame: Baseline and Day 21

Population: ITT population, which comprise of patients who have baseline and at least ONE (1) set of post-baseline PANSS assessments. No imputation on Outcome Measurement.

ArmMeasureValue (MEAN)Dispersion
Quetiapine Fumarate XRChange of the Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score Compared From Baseline to Day 21.-33.2 Scores on a scaleStandard Deviation 21.3

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