Schizophrenia
Conditions
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
Tablet, oral, once daily
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score | Baseline and Day 21 | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline to Final Visit at Day 21 in PANSS Negative, General Psychopathological Scores | Baseline and Day 21 | 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). |
| Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score | Baseline and Day 21 | 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. |
| Change From Baseline to Final Visit at Day 21 in PANSS Positive, General Psychopathological Scores. | Baseline and Day 21 | 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). |
| Change From Baseline in Absolute Clinical Global Impression-Improvement (CGI-I) Scale | Baseline and Day 21 | 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. |
| Change of the Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score Compared From Baseline to Day 21. | Baseline and 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). |
| Change From Baseline in Clinical Global Impression-Severity Scale (CGI-S) | Baseline and Day 21 | 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. |
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
| Arm | Count |
|---|---|
| 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 |
| Total | 35 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 1 |
| Overall Study | Safety Reason | 1 |
| Overall Study | Withdrawal by Subject | 5 |
Baseline characteristics
| Characteristic | Quetiapine Fumarate XR |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 35 Participants |
| Age Continuous | 38.3 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 type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 35 |
| serious Total, serious adverse events | 1 / 35 |
Outcome results
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Quetiapine Fumarate XR | Change From Baseline in Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score | -7.5 Scores on a scale | Standard Deviation 4 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Quetiapine Fumarate XR | Change From Baseline in Absolute Clinical Global Impression-Improvement (CGI-I) Scale | Baseline | 3.9 Scores on a scale | Standard Deviation 0.4 |
| Quetiapine Fumarate XR | Change From Baseline in Absolute Clinical Global Impression-Improvement (CGI-I) Scale | Day 21 | 2.4 Scores on a scale | Standard Deviation 1.2 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Quetiapine Fumarate XR | Change From Baseline in Clinical Global Impression-Severity Scale (CGI-S) | -1.2 scores on a scale | Standard Deviation 0.9 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Quetiapine Fumarate XR | Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score | -33.2 Scores on a scale | Standard Deviation 21.3 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Quetiapine Fumarate XR | Change From Baseline to Final Visit at Day 21 in PANSS Negative, General Psychopathological Scores | -5.7 Scores on a scale | Standard Deviation 4.9 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Quetiapine Fumarate XR | Change From Baseline to Final Visit at Day 21 in PANSS Positive, General Psychopathological Scores. | -9.3 Scores on a scale | Standard Deviation 5.5 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Quetiapine Fumarate XR | Change of the Positive and Negative Syndrome Scale Excited Component (PANSS-EC) Score Compared From Baseline to Day 21. | -33.2 Scores on a scale | Standard Deviation 21.3 |