Schizophrenia
Conditions
Keywords
Open Label, Aripiprazole
Brief summary
The purpose of this study is to test the long-term safety and tolerability of oral aripiprazole in adolescent patients with schizophrenia.
Interventions
Flexible dose between 5 mg and 30 mg Aripiprazole tablets.
Sponsors
Study design
Eligibility
Inclusion criteria
* Subjects with a confirmed Axis I Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of schizophrenia who must have completed Otsuka study 31-03-241 (NCT00102518) treatment of adolescent subjects with schizophrenia
Exclusion criteria
* Patients with a co-morbid serious, uncontrolled systemic illness * Patients with a significant risk of committing suicide
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuation Due to AEs and Deaths | Up to 72 months | An AE was defined as any new medical problem, or exacerbation of an existing problem, experienced by a subject. Change in clinical relevance (severity increased) was entered as a new AE in the current trial. Abnormal laboratory test findings were considered AEs if, in the opinion of the investigator, they represented an abnormal (clinically significant) change from baseline for that individual subject. An AE was considered serious if it was fatal; life-threatening; persistently or significantly disabling or incapacitating; required in-patient hospitalization or prolonged hospitalization; a congenital anomaly/birth defect; or other medically significant event that, based upon appropriate medical judgment, may have jeopardized the subject and may have required medical or surgical intervention. Additional information about Adverse Events can be found in the Adverse Event section. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Clinical Significant Laboratory Tests | Baseline, Up to 72 Months | Blood was collected for Fasting clinical laboratory tests (serum chemistry and hematology) at Baseline, Months 12, 24, 36, 48, 60, and 72 and were analyzed at a central laboratory. Clinically significant values are defined as the following: Bilirubin, total ≥ 2.0 mg/dL. Creatine phosphokinase \> 500 U/L for participants 13-17 years or 3 times the upper limit of normal for participants ≥ 18 years \[Reference Range (0 to 190 IU/L (females) and 0 to 235 IU/L (males)\]. Eosinophils ≥ 10 %. Hematocrit \< 30 % for participants 13-17 years old or ≥ 18 year old participants female ≤ 32 % and a 3 point decrease from baseline or male ≤ 37 % and a 3 point decrease from baseline. Hemoglobin female ≤ 9.5 g/dL or male ≤ 11.5 g/dL. Prolactin \> 1 times the upper limit of normal \[Reference range: 2 to 18 ng/mL (males) and 3 to 30 ng/mL (females)\]. |
| Number of Participants With Clinically Significant Heart Rate | Baseline, Up to 72 months | Heart rate was measured at Baseline and at each visit supine (lying on the back) and standing. A heart rate increase is an increase of ≥ 15 beats per minute (bpm) compared to Baseline. A heart rate decrease is a decrease of ≥ 15 bpm compared to Baseline. |
| Number of Participants With Clinically Significant Blood Pressure | Baseline, Up to 72 months | Systolic and Diastolic blood pressure was measured at Baseline and at all visits supine (lying on the back) and standing. Systolic increase was an increase of ≥ 20 mm Hg compared to Baseline and systolic decrease was a decrease of ≥ 20 mm Hg compared to Baseline. A diastolic increase was an increase of ≥ 15 mm Hg compared to Baseline and a diastolic decrease was a decrease of ≥ 15 mm Hg compared to Baseline. |
| Change From Baseline in Clinical Global Impression Severity of Illness (CGI-S) Score | Baseline, Last Visit (Up to 72 Months) | The rater or investigator answered the following question: Considering your total clinical experience with this particular population, how mentally ill is the patient at this time? Response choices included: 0=not assessed; 1=normal (not at all ill); 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill patients. A negative change from Baseline indicated improvement |
| Number of Participants Showing Significant Weight Gain or Loss | Baseline, Up to 72 months | Weight was measured at Baseline, Months 6, 12, 18, 24, 30, 36, 42, 48, 54, 60, 66, and 72. A clinically significant weight gain was defined as a ≥ 7 % increase from Baseline. A clinically significant Weight loss was defined as a ≥ 7% decrease from Baseline. |
| Number of Participants Experiencing Suicidal Ideation or Suicidal Behavior Based on Columbia-Suicide Severity Rating Scale (C-SSRS) | Baseline, Up to 72 months | The C-SSRS consisted of a baseline evaluation (completed at the first scheduled visit upon approval of protocol Amendment 3) that assessed the lifetime experience of the participant with suicide events and suicidal ideation and a post-baseline evaluation at each visit that focused on suicidality since the last trial visit. Some questions are yes/no and some are on a scale of 1 (low severity) to 5 (high severity). The number of participants experiencing suicidal ideation or suicidal behavior is reported. |
| Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | Baseline, Up to 72 months | A 12-lead ECG was recorded at Baseline, Months 6, 12, 24, 36, 48, 60 and 72. Three readings taken 5 minutes were read by a central ECG reading service and averaged. Clinically significant ECGs were defined as: Sinus Bradycardia: ≤ 50 beats per minute (bpm), decrease of ≥ 15 bpm from Baseline. Supraventricular premature beat: ≥ 2 per 10 seconds, increase from Baseline. Ventricular premature beat: ≥ 1 per 10 seconds, increase from Baseline. Right bundle branch block: present. Other intraventricular block: QRS ≥ 0.10 seconds for age 13-17 years or QRS ≥ 0.11 seconds for age ≥ 18 years, an increase of ≥ 0.02 seconds from Baseline. Symmetrical T-wave inversion: present. QTcB (QT interval corrected Bazett's formula), QTcF (QT interval corrected Fridericia's formula), QTcN (QT corrected FDA Neuropharmacology Division formula), QTcE (QT corrected fractional exponent correction method: ≥ 420 msec for age 13-17 years or ≥ 450 msec for age ≥ 18 years, ≥ 10 % increase from Baseline. |
Countries
Argentina, Croatia, India, Russia, Serbia, Ukraine
Participant flow
Pre-assignment details
An open-label rollover study for participants who completed study 31-03-241 (NCT00102518). The withdrawal criteria for this open label rollover study was completion by 31 December 2012 (or if Month 72 occurred within 6 months of this date) or if there was commercial availability.
Participants by arm
| Arm | Count |
|---|---|
| Oral Aripiprazole Flexible dose of oral aripiprazole between 5 mg and 30 mg once daily for 72 months. | 85 |
| Total | 85 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 7 |
| Overall Study | Investigator withdrew Subject | 10 |
| Overall Study | Lack of Efficacy per Investigator | 3 |
| Overall Study | Lost to Follow-up | 7 |
| Overall Study | Sponsor Discontinued Study | 4 |
| Overall Study | Subject met Withdrawal Criteria | 22 |
| Overall Study | Withdrawal by Subject | 19 |
Baseline characteristics
| Characteristic | Oral Aripiprazole |
|---|---|
| Age Continuous | 16.29 years STANDARD_DEVIATION 1.36 |
| Sex: Female, Male Female | 42 Participants |
| Sex: Female, Male Male | 43 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 45 / 85 |
| serious Total, serious adverse events | 11 / 85 |
Outcome results
Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuation Due to AEs and Deaths
An AE was defined as any new medical problem, or exacerbation of an existing problem, experienced by a subject. Change in clinical relevance (severity increased) was entered as a new AE in the current trial. Abnormal laboratory test findings were considered AEs if, in the opinion of the investigator, they represented an abnormal (clinically significant) change from baseline for that individual subject. An AE was considered serious if it was fatal; life-threatening; persistently or significantly disabling or incapacitating; required in-patient hospitalization or prolonged hospitalization; a congenital anomaly/birth defect; or other medically significant event that, based upon appropriate medical judgment, may have jeopardized the subject and may have required medical or surgical intervention. Additional information about Adverse Events can be found in the Adverse Event section.
Time frame: Up to 72 months
Population: Safety population included all participants who received at least one dose of study drug.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Oral Aripiprazole | Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuation Due to AEs and Deaths | AEs | 61 Participants |
| Oral Aripiprazole | Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuation Due to AEs and Deaths | SAEs | 11 Participants |
| Oral Aripiprazole | Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuation Due to AEs and Deaths | Discontinuation due to AEs | 7 Participants |
| Oral Aripiprazole | Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuation Due to AEs and Deaths | Death | 1 Participants |
Change From Baseline in Clinical Global Impression Severity of Illness (CGI-S) Score
The rater or investigator answered the following question: Considering your total clinical experience with this particular population, how mentally ill is the patient at this time? Response choices included: 0=not assessed; 1=normal (not at all ill); 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill patients. A negative change from Baseline indicated improvement
Time frame: Baseline, Last Visit (Up to 72 Months)
Population: Participants with baseline assessment and at least one post-baseline measurement for analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Oral Aripiprazole | Change From Baseline in Clinical Global Impression Severity of Illness (CGI-S) Score | -0.26 Score on a scale | Standard Deviation 1.07 |
Number of Participants Experiencing Suicidal Ideation or Suicidal Behavior Based on Columbia-Suicide Severity Rating Scale (C-SSRS)
The C-SSRS consisted of a baseline evaluation (completed at the first scheduled visit upon approval of protocol Amendment 3) that assessed the lifetime experience of the participant with suicide events and suicidal ideation and a post-baseline evaluation at each visit that focused on suicidality since the last trial visit. Some questions are yes/no and some are on a scale of 1 (low severity) to 5 (high severity). The number of participants experiencing suicidal ideation or suicidal behavior is reported.
Time frame: Baseline, Up to 72 months
Population: All participants with available assessment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Oral Aripiprazole | Number of Participants Experiencing Suicidal Ideation or Suicidal Behavior Based on Columbia-Suicide Severity Rating Scale (C-SSRS) | 0 Participants |
Number of Participants Showing Significant Weight Gain or Loss
Weight was measured at Baseline, Months 6, 12, 18, 24, 30, 36, 42, 48, 54, 60, 66, and 72. A clinically significant weight gain was defined as a ≥ 7 % increase from Baseline. A clinically significant Weight loss was defined as a ≥ 7% decrease from Baseline.
Time frame: Baseline, Up to 72 months
Population: Participants with baseline assessment and at least one post-baseline numeric result for the given parameter.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Oral Aripiprazole | Number of Participants Showing Significant Weight Gain or Loss | Weight Gain | 37 Participants |
| Oral Aripiprazole | Number of Participants Showing Significant Weight Gain or Loss | Weight Loss | 4 Participants |
Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations
A 12-lead ECG was recorded at Baseline, Months 6, 12, 24, 36, 48, 60 and 72. Three readings taken 5 minutes were read by a central ECG reading service and averaged. Clinically significant ECGs were defined as: Sinus Bradycardia: ≤ 50 beats per minute (bpm), decrease of ≥ 15 bpm from Baseline. Supraventricular premature beat: ≥ 2 per 10 seconds, increase from Baseline. Ventricular premature beat: ≥ 1 per 10 seconds, increase from Baseline. Right bundle branch block: present. Other intraventricular block: QRS ≥ 0.10 seconds for age 13-17 years or QRS ≥ 0.11 seconds for age ≥ 18 years, an increase of ≥ 0.02 seconds from Baseline. Symmetrical T-wave inversion: present. QTcB (QT interval corrected Bazett's formula), QTcF (QT interval corrected Fridericia's formula), QTcN (QT corrected FDA Neuropharmacology Division formula), QTcE (QT corrected fractional exponent correction method: ≥ 420 msec for age 13-17 years or ≥ 450 msec for age ≥ 18 years, ≥ 10 % increase from Baseline.
Time frame: Baseline, Up to 72 months
Population: Participants with at least one post-baseline numeric result for the given parameter.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | Sinus bradycardia | 7 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | Supraventricular premature beat | 6 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | Ventricular premature beat | 1 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | Right bundle branch block | 1 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | Other intraventricular block | 5 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | Symmetrical T-wave inversion | 1 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | QTcB | 9 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | QTcF | 4 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | QTcN | 6 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Abnormal Changes in Electrocardiograms (ECGs) Evaluations | QTcE | 5 Participants |
Number of Participants With Clinically Significant Blood Pressure
Systolic and Diastolic blood pressure was measured at Baseline and at all visits supine (lying on the back) and standing. Systolic increase was an increase of ≥ 20 mm Hg compared to Baseline and systolic decrease was a decrease of ≥ 20 mm Hg compared to Baseline. A diastolic increase was an increase of ≥ 15 mm Hg compared to Baseline and a diastolic decrease was a decrease of ≥ 15 mm Hg compared to Baseline.
Time frame: Baseline, Up to 72 months
Population: Participants with baseline assessment and at least one post-baseline numeric result for the given parameter.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Supine Systolic Blood Pressure Increase | 4 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Supine Systolic Blood Pressure Decrease | 3 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Standing Systolic Blood Pressure Increase | 5 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Standing Systolic Blood Pressure Decrease | 2 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Supine Diastolic Blood Pressure Increase | 5 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Supine Diastolic Blood Pressure Decrease | 0 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Standing Diastolic Blood Pressure Increase | 5 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Blood Pressure | Standing Diastolic Blood Pressure Decrease | 0 Participants |
Number of Participants With Clinically Significant Heart Rate
Heart rate was measured at Baseline and at each visit supine (lying on the back) and standing. A heart rate increase is an increase of ≥ 15 beats per minute (bpm) compared to Baseline. A heart rate decrease is a decrease of ≥ 15 bpm compared to Baseline.
Time frame: Baseline, Up to 72 months
Population: Participants with baseline assessment and at least one post-baseline numeric result for the given parameter.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Oral Aripiprazole | Number of Participants With Clinically Significant Heart Rate | Supine Heart Rate Increase | 0 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Heart Rate | Supine Heart Rate Decrease | 0 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Heart Rate | Standing Heart Rate Increase | 1 Participants |
| Oral Aripiprazole | Number of Participants With Clinically Significant Heart Rate | Standing Heart Rate Decrease | 0 Participants |
Number of Participants With Clinical Significant Laboratory Tests
Blood was collected for Fasting clinical laboratory tests (serum chemistry and hematology) at Baseline, Months 12, 24, 36, 48, 60, and 72 and were analyzed at a central laboratory. Clinically significant values are defined as the following: Bilirubin, total ≥ 2.0 mg/dL. Creatine phosphokinase \> 500 U/L for participants 13-17 years or 3 times the upper limit of normal for participants ≥ 18 years \[Reference Range (0 to 190 IU/L (females) and 0 to 235 IU/L (males)\]. Eosinophils ≥ 10 %. Hematocrit \< 30 % for participants 13-17 years old or ≥ 18 year old participants female ≤ 32 % and a 3 point decrease from baseline or male ≤ 37 % and a 3 point decrease from baseline. Hemoglobin female ≤ 9.5 g/dL or male ≤ 11.5 g/dL. Prolactin \> 1 times the upper limit of normal \[Reference range: 2 to 18 ng/mL (males) and 3 to 30 ng/mL (females)\].
Time frame: Baseline, Up to 72 Months
Population: Participants with at least one post-baseline numeric result for the given laboratory test are included in the analysis.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Oral Aripiprazole | Number of Participants With Clinical Significant Laboratory Tests | Bilirubin, total (mg/dL) | 7 Participants |
| Oral Aripiprazole | Number of Participants With Clinical Significant Laboratory Tests | Creatine phosphokinase (CPK), total (IU/L) | 6 Participants |
| Oral Aripiprazole | Number of Participants With Clinical Significant Laboratory Tests | Eosinophils (%) | 5 Participants |
| Oral Aripiprazole | Number of Participants With Clinical Significant Laboratory Tests | Hematocrit (%) | 5 Participants |
| Oral Aripiprazole | Number of Participants With Clinical Significant Laboratory Tests | Hemoglobin (g/dL) | 3 Participants |
| Oral Aripiprazole | Number of Participants With Clinical Significant Laboratory Tests | Prolactin (ng/mL) | 3 Participants |