Schizophrenia
Conditions
Keywords
Schizophrenia, Acute schizophrenia, Psychotropic drugs, Antipsychotic agents, Mental disorders, Dopamine agents, Central nervous system agents
Brief summary
The objective of this study is to evaluate the long-term safety, tolerability, and pharmacokinetics of cariprazine in patients with schizophrenia.
Interventions
Cariprazine was supplied in capsules.
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients and corresponding caregivers who have provided informed consents prior to any study specific procedures. * Patients currently meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for schizophrenia (paranoid type, disorganized type, catatonic type, or undifferentiated type), as confirmed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). * Patients with normal physical examination, laboratory, vital signs, and electrocardiogram (ECG).
Exclusion criteria
* Patients with a DSM-IV-TR diagnosis of schizoaffective disorder, schizophreniform disorder, bipolar I or bipolar II disorder, or psychotic disorders other than schizophrenia.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline to Week 48 in the PANSS Total Score | Baseline to Week 48 | The Positive and Negative Syndrome Scale (PANSS) is a 30-item rating scale that assesses the positive and negative symptoms of individuals with schizophrenia. Responses to the 30 items are based on a structured clinical interview with the patient and on supporting clinical information obtained from family, hospital staff, or other reliable informants. Of the 30 psychiatric parameters measured by the scale, 7 assess positive symptoms (eg, delusions, grandiosity); 7 assess negative symptoms (eg, blunted affect, emotional withdrawal); and 16 assess general psychopathology (eg, poor attention, active social avoidance). Each item is scored on a 7-point scale (1 = absent, 2 = minimal, 3 = mild, 4 = moderate, 5 = moderately severe, 6 = severe, and 7 = extreme). The PANSS total score can range from 30 to 210. A higher score indicates worse symptoms. A negative change score indicates improvement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline to Week 48 in the CGI-S Score | Baseline to Week 48 | The Clinical Global Impressions-Severity (CGI-S) scale is a 7-point scale that measures the overall severity of the illness compared with the severity of illness in other patients the Investigator has observed. The Investigator assesses the severity of the patient's illness as one of the following: 1 = Normal, not at all ill; 2 = Borderline ill; 3 = Mildly ill; 4 = Moderately ill; 5 = Markedly ill; 6 = Severely ill; 7 = Among the most extremely ill patients. The CGI-S score can range from 1 to 7. A higher score indicates more severe illness. A negative change score indicates improvement. |
Countries
Colombia, India, Romania, Russia, Ukraine, United States
Participant flow
Pre-assignment details
The flexible-dose design for this study was selected to examine the relative safety and tolerability of a range of dosages of cariprazine. The starting dose of 1.5 mg/day was titrated as needed within the range of 3.0 - 9.0 mg/day based on the Investigator's judgment of response and tolerability.
Participants by arm
| Arm | Count |
|---|---|
| Cariprazine Participants received cariprazine 3.0, 4.5, 6.0, or 9.0 mg orally once a day for 48 weeks. | 586 |
| Total | 586 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 77 |
| Overall Study | Did Not Meet Eligibility Criteria | 133 |
| Overall Study | Insufficient Therapeutic Response | 22 |
| Overall Study | Lost to Follow-up | 43 |
| Overall Study | Protocol Violation | 45 |
| Overall Study | Reasons Not Specified | 27 |
| Overall Study | Withdrawal of Consent | 179 |
Baseline characteristics
| Characteristic | Cariprazine |
|---|---|
| Age, Continuous | 39.1 years STANDARD_DEVIATION 10.8 |
| Body Mass Index (BMI) | 27.10 kg/m^2 STANDARD_DEVIATION 5.8 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 48 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 523 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 15 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants |
| Race (NIH/OMB) Asian | 68 Participants |
| Race (NIH/OMB) Black or African American | 229 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 3 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 35 Participants |
| Race (NIH/OMB) White | 250 Participants |
| Sex: Female, Male Female | 178 Participants |
| Sex: Female, Male Male | 408 Participants |
| Waist circumference | 91.76 cm STANDARD_DEVIATION 15.85 |
| Weight | 79.94 kg STANDARD_DEVIATION 20.26 |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 586 |
| other Total, other adverse events | 419 / 586 |
| serious Total, serious adverse events | 59 / 586 |
Outcome results
Change From Baseline to Week 48 in the PANSS Total Score
The Positive and Negative Syndrome Scale (PANSS) is a 30-item rating scale that assesses the positive and negative symptoms of individuals with schizophrenia. Responses to the 30 items are based on a structured clinical interview with the patient and on supporting clinical information obtained from family, hospital staff, or other reliable informants. Of the 30 psychiatric parameters measured by the scale, 7 assess positive symptoms (eg, delusions, grandiosity); 7 assess negative symptoms (eg, blunted affect, emotional withdrawal); and 16 assess general psychopathology (eg, poor attention, active social avoidance). Each item is scored on a 7-point scale (1 = absent, 2 = minimal, 3 = mild, 4 = moderate, 5 = moderately severe, 6 = severe, and 7 = extreme). The PANSS total score can range from 30 to 210. A higher score indicates worse symptoms. A negative change score indicates improvement.
Time frame: Baseline to Week 48
Population: Intent-to-treat population: All participants who took at least 1 dose of cariprazine and who had at least 1 post-baseline efficacy assessment. Only participants with data at both Baseline and Week 48 were included in the analysis.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Cariprazine | Change From Baseline to Week 48 in the PANSS Total Score | Baseline | 66.5 Units on a scale | Standard Deviation 12.1 |
| Cariprazine | Change From Baseline to Week 48 in the PANSS Total Score | Change From Baseline | -5.0 Units on a scale | Standard Deviation 14 |
Change From Baseline to Week 48 in the CGI-S Score
The Clinical Global Impressions-Severity (CGI-S) scale is a 7-point scale that measures the overall severity of the illness compared with the severity of illness in other patients the Investigator has observed. The Investigator assesses the severity of the patient's illness as one of the following: 1 = Normal, not at all ill; 2 = Borderline ill; 3 = Mildly ill; 4 = Moderately ill; 5 = Markedly ill; 6 = Severely ill; 7 = Among the most extremely ill patients. The CGI-S score can range from 1 to 7. A higher score indicates more severe illness. A negative change score indicates improvement.
Time frame: Baseline to Week 48
Population: Intent-to-treat population: All participants who took at least 1 dose of cariprazine and who had at least 1 post-baseline efficacy assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Cariprazine | Change From Baseline to Week 48 in the CGI-S Score | Baseline | 3.0 Units on a scale | Standard Deviation 0.4 |
| Cariprazine | Change From Baseline to Week 48 in the CGI-S Score | Change From Baseline | -0.1 Units on a scale | Standard Deviation 0.8 |