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Safety, Tolerability, and Pharmacokinetic Study of EVP-6124 in Patients With Schizophrenia

A Double-Blind, Placebo-Controlled Randomized Study to Assess the Safety, Tolerability, and Pharmacokinetics of EVP-6124 in Participants With Schizophrenia on Stable Monotherapy With Selected Antipsychotics

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01556763
Enrollment
21
Registered
2012-03-16
Start date
2008-04-30
Completion date
2008-08-31
Last updated
2012-06-21

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

Conditions

Central Nervous System Diseases, Schizoaffective Disorder, Schizophrenia

Keywords

Schizophrenia, Schizoaffective, CNS

Brief summary

This study in patients with schizophrenia is designed to provide preliminary evidence of the safety, tolerability, and pharmacokinetics as well as the effects on cognitive function of 2 doses of EVP-6124 compared with placebo when given with the patient's usual antipsychotic medication.

Detailed description

Study drug will be supplied as capsules and will be orally administered once daily for a total of 21 days. Eligible subjects will be admitted to an inpatient study unit on Day -6 (six days before the first dose of study drug is administered) and will remain confined to the inpatient study unit throughout the dosing phase. Safety assessments, PK sampling, and cognitive testing will be performed.

Interventions

EVP-6124 was administered as one 0.3 mg capsule per day for 21 days.

EVP-6124 was administered as one 1.0 mg capsule per day for 21 days.

DRUGPlacebo

Matching placebo was administered as one capsule per day for 21 days.

DRUGAntipsychotic therapy

Concomitant therapy with antipsychotic medication (aripiprazole \[10 to 30 mg/day\], olanzapine \[10 to 20 mg/day\], paliperidone \[3 to 12 mg/day\], or risperidone \[2 to 16 mg/day\]), taken at the same time each day as the EVP-6124 dose. Patients must have been taking concomitant therapy for at least 2 weeks at a stable dose to be eligible for the study.

Sponsors

FORUM Pharmaceuticals Inc
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 55 Years
Healthy volunteers
No

Inclusion criteria

* Male or female aged 18 to 55 years (both inclusive). * Females must be surgically sterile, post-menopausal, or using reliable contraception and have negative pregnancy tests at screening and at Day -1. * A clinical diagnosis of schizophrenia or schizoaffective disorder and prescribed a stable dose of aripiprazole (10 to 30 mg/day), olanzapine (10 to 20 mg/day), paliperidone (3 to 12 mg/day), or risperidone (2 to 16 mg/day) for a minimum of 2 weeks before initial screening. * In good general health and expected to complete the clinical trial as designed. * Body Mass Index (BMI) of 18 kg/m\^2 to 38 kg/m\^2 (both inclusive) at screening. * Adequate hearing, vision, and language skills to perform the cognitive testing and other procedures specified in the protocol. * Voluntarily provided informed consent and signed an informed consent form (ICF) indicating that the purpose of the study was explained, and was willing and able to adhere to the study regimen and study procedures described in the ICF, including all confinement requirements. * Negative urine drug screen at screening and inpatient observation baseline period (Day -6), except for a short-acting benzodiazepine if prescribed for insomnia. * Fluent in English (speaking, writing, and reading).

Exclusion criteria

* Female subject who was pregnant or breast-feeding. * Any active clinically significant medical condition within 1 month (30 days) prior to screening. * A history of substance (drug) dependence or substance or alcohol abuse within the 12 months before randomization as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). * A score of \>5 on any item on the PANSS (Positive and Negative Syndrome Scale) Positive subscale at baseline during the inpatient observation period (Day -1). * Any laboratory test abnormalities at screening indicating hepatic or renal dysfunction, or any other laboratory test abnormalities deemed by the investigator to be clinically significant. * Any hematologic malignancy or solid tumor diagnosed within 3 years prior to study entry with the exception of localized skin cancer or carcinoma in situ of the cervix. * Known to have had or was a carrier of HBsAg, HCV antibody, or had a positive result to the HIV-1 and/or HIV-2 antibodies. * Uncooperative with or could not complete the study procedures. * Received an investigational drug within 30 days before screening. * Donated blood within 30 days before randomization on Day 1.

Design outcomes

Primary

MeasureTime frameDescription
EVP-6124 Half-life (T[1/2]), Patients on Paliperidone/RisperidoneDays 1 and 21Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.
EVP-6124 Half-life (T[1/2]), Patients on AripiprazoleDays 1 and 21Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.
EVP-6124 Maximum Plasma Concentration (Cmax), Patients on Paliperidone/RisperidoneDays 1 and 21Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.
EVP-6124 Time to Maximum Concentration (Tmax), Patients on Paliperidone/RisperidoneDays 1 and 21Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.
EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on Paliperidone/RisperidoneDays 1 and 21Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.
Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.Screening (Day -5 for continuous cardiac monitoring) to Day 22Safety and tolerability was measured by number of reported adverse events (serious and non-serious) and repeated clinical evaluation of physical examinations, vital signs, 12-lead electrocardiogram (ECG), 24-hour continuous cardiac monitoring, and laboratory tests (hematology/blood chemistry/urinalysis).
EVP-6124 Maximum Plasma Concentration (Cmax), Patients on AripiprazoleDays 1 and 21Blood samples for pharmacokinetic (PK) analyses were taken before dosing with EVP-6124 on Days 1 and 21.
EVP-6124 Time to Maximum Concentration (Tmax), Patients on AripiprazoleDays 1 and 21Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.
EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on AripiprazoleDays 1 and 21Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Secondary

MeasureTime frameDescription
P50 Amplitude DifferenceDays -1 to 20P50 auditory evoked potential response (amplitude measured in microvolts) using sensory gating paradigm. Measured by EEG as amplitude difference (conditioning stimulus minus test stimulus). Plotted on a scale of -0.2 to 0.8 microvolts. Normalization is suggested by a higher value.
MMN Summed AmplitudeDays -1 to 20Mismatch negativity (MMN) auditory evoked potential response (amplitude in microvolts) using orienting paradigm. Measured by EEG and calculated as the voltage difference over 100-200 msec following stimulus onset (rare stimulus minus frequent stimulus). Plotted on a scale of -1.2 to 0.2 microvolts. Normalization is suggested by a more negative value.
P300 Peak AmplitudeDays -1 to 20P300 auditory evoked potential response (amplitude in microvolts) using orienting paradigm. Measured by EEG and calculated as the peak amplitude over 250-500 msec following stimulus onset (rare stimulus minus frequent stimulus). Plotted on a scale of -0.4 to 1.2 microvolts. Normalization is suggested by a more positive value.
N100 Gating RatioDays -1 to 20N100 auditory evoked potential response (amplitude measured in microvolts) using the sensory gating paradigm. Measured by electroencephalography (EEG) as the amplitude ratio of test stimulus to conditioning stimulus. Plotted on a unitless scale of 0 to 2. Normalization is suggested by a lower value.

Countries

United States

Participant flow

Participants by arm

ArmCount
Placebo
Matching placebo was administered as one capsule per day for 21 days.
4
EVP-6124 (1.0 mg/Day)
EVP-6124 was administered as one 1.0 mg capsule per day for 21 days.
9
EVP-6124 (0.3 mg/Day)
EVP-6124 was administered as one 0.3 mg capsule per day for 21 days.
8
Total21

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyWithdrawal by Subject010

Baseline characteristics

CharacteristicEVP-6124 (1.0 mg/Day)EVP-6124 (0.3 mg/Day)PlaceboTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
9 Participants8 Participants4 Participants21 Participants
Age Continuous43.1 years
STANDARD_DEVIATION 11
51.4 years
STANDARD_DEVIATION 6.9
40.0 years
STANDARD_DEVIATION 11.6
45.7 years
STANDARD_DEVIATION 10.4
Region of Enrollment
United States
9 participants8 participants4 participants21 participants
Sex: Female, Male
Female
3 Participants3 Participants0 Participants6 Participants
Sex: Female, Male
Male
6 Participants5 Participants4 Participants15 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
0 / 45 / 95 / 8
serious
Total, serious adverse events
0 / 40 / 91 / 8

Outcome results

Primary

EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on Aripiprazole

Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: All patients receiving aripiprazole.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboEVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on AripiprazoleDay 110,966 pg*hr/mLStandard Deviation 2831
PlaceboEVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on AripiprazoleDay 2142,042 pg*hr/mLStandard Deviation 9623
EVP-6124 (1.0 mg/Day)EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on AripiprazoleDay 13838 pg*hr/mLStandard Deviation 1044
EVP-6124 (1.0 mg/Day)EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on AripiprazoleDay 2120,560 pg*hr/mLStandard Deviation 2699
Primary

EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on Paliperidone/Risperidone

Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: All patients receiving paliperidone/risperidone.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboEVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on Paliperidone/RisperidoneDay 16359 pg*hr/ml
PlaceboEVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on Paliperidone/RisperidoneDay 2133,042 pg*hr/ml
EVP-6124 (1.0 mg/Day)EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on Paliperidone/RisperidoneDay 13110 pg*hr/mlStandard Deviation 852
EVP-6124 (1.0 mg/Day)EVP-6124 Area Under the Curve (AUC[0-24 h]), Patients on Paliperidone/RisperidoneDay 2111,888 pg*hr/mlStandard Deviation 3095
Primary

EVP-6124 Half-life (T[1/2]), Patients on Aripiprazole

Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: Patients receiving aripiprazole for whom blood samples were available for analysis.

ArmMeasureGroupValue (MEAN)
PlaceboEVP-6124 Half-life (T[1/2]), Patients on AripiprazoleDay 139.0 hr
PlaceboEVP-6124 Half-life (T[1/2]), Patients on AripiprazoleDay 21NA hr
EVP-6124 (1.0 mg/Day)EVP-6124 Half-life (T[1/2]), Patients on AripiprazoleDay 143.1 hr
EVP-6124 (1.0 mg/Day)EVP-6124 Half-life (T[1/2]), Patients on AripiprazoleDay 21116.6 hr
Primary

EVP-6124 Half-life (T[1/2]), Patients on Paliperidone/Risperidone

Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: Patients receiving paliperidone/risperidone for whom blood samples were available for analysis.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboEVP-6124 Half-life (T[1/2]), Patients on Paliperidone/RisperidoneDay 192.0 hr
PlaceboEVP-6124 Half-life (T[1/2]), Patients on Paliperidone/RisperidoneDay 21NA hr
EVP-6124 (1.0 mg/Day)EVP-6124 Half-life (T[1/2]), Patients on Paliperidone/RisperidoneDay 145.8 hrStandard Deviation 17.7
EVP-6124 (1.0 mg/Day)EVP-6124 Half-life (T[1/2]), Patients on Paliperidone/RisperidoneDay 2178.1 hrStandard Deviation 8.3
Primary

EVP-6124 Maximum Plasma Concentration (Cmax), Patients on Aripiprazole

Blood samples for pharmacokinetic (PK) analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: All patients receiving aripiprazole.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboEVP-6124 Maximum Plasma Concentration (Cmax), Patients on AripiprazoleDay 1581.0 pg/mLStandard Deviation 149.8
PlaceboEVP-6124 Maximum Plasma Concentration (Cmax), Patients on AripiprazoleDay 212058.6 pg/mLStandard Deviation 393.2
EVP-6124 (1.0 mg/Day)EVP-6124 Maximum Plasma Concentration (Cmax), Patients on AripiprazoleDay 1210.0 pg/mLStandard Deviation 39.3
EVP-6124 (1.0 mg/Day)EVP-6124 Maximum Plasma Concentration (Cmax), Patients on AripiprazoleDay 21968.3 pg/mLStandard Deviation 90.1
Primary

EVP-6124 Maximum Plasma Concentration (Cmax), Patients on Paliperidone/Risperidone

Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: All patients receiving paliperidone/risperidone.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboEVP-6124 Maximum Plasma Concentration (Cmax), Patients on Paliperidone/RisperidoneDay 1315.0 pg/mL
PlaceboEVP-6124 Maximum Plasma Concentration (Cmax), Patients on Paliperidone/RisperidoneDay 211510.0 pg/mL
EVP-6124 (1.0 mg/Day)EVP-6124 Maximum Plasma Concentration (Cmax), Patients on Paliperidone/RisperidoneDay 1165.0 pg/mLStandard Deviation 40.2
EVP-6124 (1.0 mg/Day)EVP-6124 Maximum Plasma Concentration (Cmax), Patients on Paliperidone/RisperidoneDay 21545.4 pg/mLStandard Deviation 130.2
Primary

EVP-6124 Time to Maximum Concentration (Tmax), Patients on Aripiprazole

Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: All patients receiving aripiprazole.

ArmMeasureGroupValue (MEDIAN)
PlaceboEVP-6124 Time to Maximum Concentration (Tmax), Patients on AripiprazoleDay 18.0 hr
PlaceboEVP-6124 Time to Maximum Concentration (Tmax), Patients on AripiprazoleDay 216.0 hr
EVP-6124 (1.0 mg/Day)EVP-6124 Time to Maximum Concentration (Tmax), Patients on AripiprazoleDay 18.0 hr
EVP-6124 (1.0 mg/Day)EVP-6124 Time to Maximum Concentration (Tmax), Patients on AripiprazoleDay 218.0 hr
Primary

EVP-6124 Time to Maximum Concentration (Tmax), Patients on Paliperidone/Risperidone

Blood samples for PK analyses were taken before dosing with EVP-6124 on Days 1 and 21.

Time frame: Days 1 and 21

Population: All patients receiving paliperidone/risperidone.

ArmMeasureGroupValue (MEDIAN)
PlaceboEVP-6124 Time to Maximum Concentration (Tmax), Patients on Paliperidone/RisperidoneDay 16.0 hr
PlaceboEVP-6124 Time to Maximum Concentration (Tmax), Patients on Paliperidone/RisperidoneDay 216.0 hr
EVP-6124 (1.0 mg/Day)EVP-6124 Time to Maximum Concentration (Tmax), Patients on Paliperidone/RisperidoneDay 18.0 hr
EVP-6124 (1.0 mg/Day)EVP-6124 Time to Maximum Concentration (Tmax), Patients on Paliperidone/RisperidoneDay 218.0 hr
Primary

Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.

Safety and tolerability was measured by number of reported adverse events (serious and non-serious) and repeated clinical evaluation of physical examinations, vital signs, 12-lead electrocardiogram (ECG), 24-hour continuous cardiac monitoring, and laboratory tests (hematology/blood chemistry/urinalysis).

Time frame: Screening (Day -5 for continuous cardiac monitoring) to Day 22

Population: All randomized patients who ingested at least one dose of study drug or placebo.

ArmMeasureGroupValue (NUMBER)Dispersion
PlaceboNumber of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.Non-Serious Adverse Events0 participants 0
PlaceboNumber of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.Serious Adverse Events0 participants 0
PlaceboNumber of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.No Adverse Events Reported4 participants 0
EVP-6124 (1.0 mg/Day)Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.Non-Serious Adverse Events5 participants 0
EVP-6124 (1.0 mg/Day)Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.Serious Adverse Events0 participants 0
EVP-6124 (1.0 mg/Day)Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.No Adverse Events Reported4 participants 0
EVP-6124 (0.3 mg/Day)Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.Serious Adverse Events1 participants 0
EVP-6124 (0.3 mg/Day)Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.No Adverse Events Reported3 participants 0
EVP-6124 (0.3 mg/Day)Number of Participants With Serious and Non-serious Adverse Events Spontaneously Reported by Subject and/or Observed by Investigator.Non-Serious Adverse Events5 participants 0
Secondary

MMN Summed Amplitude

Mismatch negativity (MMN) auditory evoked potential response (amplitude in microvolts) using orienting paradigm. Measured by EEG and calculated as the voltage difference over 100-200 msec following stimulus onset (rare stimulus minus frequent stimulus). Plotted on a scale of -1.2 to 0.2 microvolts. Normalization is suggested by a more negative value.

Time frame: Days -1 to 20

Population: Subjects providing valid and measurable MMN responses.

ArmMeasureValue (MEAN)Dispersion
PlaceboMMN Summed Amplitude0.14 microvoltsStandard Error 0.33
EVP-6124 (1.0 mg/Day)MMN Summed Amplitude-1.15 microvoltsStandard Error 0.24
EVP-6124 (0.3 mg/Day)MMN Summed Amplitude-0.61 microvoltsStandard Error 0.25
Comparison: Baseline value was the covariate and all values obtained during the treatment period were averaged together. This value was adjusted by regression against the baseline and estimation of a new value as if all subjects possessed the same baseline.p-value: =0.02ANCOVA
Secondary

N100 Gating Ratio

N100 auditory evoked potential response (amplitude measured in microvolts) using the sensory gating paradigm. Measured by electroencephalography (EEG) as the amplitude ratio of test stimulus to conditioning stimulus. Plotted on a unitless scale of 0 to 2. Normalization is suggested by a lower value.

Time frame: Days -1 to 20

Population: Subjects providing valid and measurable N100 responses.

ArmMeasureValue (MEAN)Dispersion
PlaceboN100 Gating Ratio1.648 ratioStandard Error 0.29
EVP-6124 (1.0 mg/Day)N100 Gating Ratio0.801 ratioStandard Error 0.19
EVP-6124 (0.3 mg/Day)N100 Gating Ratio0.951 ratioStandard Error 0.2
Comparison: Baseline value was the covariate and all values obtained during the treatment period were averaged together. This value was adjusted by regression against the baseline and estimation of a new value as if all subjects possessed the same baseline.p-value: =0.1ANCOVA
Secondary

P300 Peak Amplitude

P300 auditory evoked potential response (amplitude in microvolts) using orienting paradigm. Measured by EEG and calculated as the peak amplitude over 250-500 msec following stimulus onset (rare stimulus minus frequent stimulus). Plotted on a scale of -0.4 to 1.2 microvolts. Normalization is suggested by a more positive value.

Time frame: Days -1 to 20

Population: Subjects providing valid and measurable P300 responses.

ArmMeasureValue (MEAN)Dispersion
PlaceboP300 Peak Amplitude-0.3 microvoltsStandard Error 0.31
EVP-6124 (1.0 mg/Day)P300 Peak Amplitude1.08 microvoltsStandard Error 0.22
EVP-6124 (0.3 mg/Day)P300 Peak Amplitude0.78 microvoltsStandard Error 0.24
Comparison: Baseline value was the covariate and all values obtained during the treatment period were averaged together. This value was adjusted by regression against the baseline and estimation of a new value as if all subjects possessed the same baseline.p-value: =0.008ANCOVA
Secondary

P50 Amplitude Difference

P50 auditory evoked potential response (amplitude measured in microvolts) using sensory gating paradigm. Measured by EEG as amplitude difference (conditioning stimulus minus test stimulus). Plotted on a scale of -0.2 to 0.8 microvolts. Normalization is suggested by a higher value.

Time frame: Days -1 to 20

Population: Subjects providing valid and measurable P50 responses.

ArmMeasureValue (MEAN)Dispersion
PlaceboP50 Amplitude Difference-0.17 microvoltsStandard Error 0.38
EVP-6124 (1.0 mg/Day)P50 Amplitude Difference0.67 microvoltsStandard Error 0.21
EVP-6124 (0.3 mg/Day)P50 Amplitude Difference-0.06 microvoltsStandard Error 0.25
Comparison: Baseline value was the covariate and all values obtained during the treatment period were averaged together. This value was adjusted by regression against the baseline and estimation of a new value as if all subjects possessed the same baseline.p-value: =0.07ANCOVA

Source: ClinicalTrials.gov · Data processed: Mar 21, 2026