MedPath

Effect of Lu AF35700 in Patients With Treatment-resistant Schizophrenia

Phase 3
Completed
Conditions
Schizophrenia
Interventions
Registration Number
NCT02717195
Lead Sponsor
H. Lundbeck A/S
Brief Summary

To evaluate the efficacy of 10 and 20 mg/day of Lu AF35700 on schizophrenia symptoms in patients with treatment-resistant schizophrenia (TRS)

Detailed Description

The study consists of a Screening Period (3 weeks), a single-blind Prospective Confirmation (PC) Period (6 weeks), a Double-blind Treatment (DBT) Period (10 weeks), and a Safety Follow-up Period (6 weeks).

Patients who did not fulfil the randomization criteria for the DBT Period, were withdrawn from the study after the PC period.

Patients who fulfilled the randomization criteria for the DBT Period, continued into the DBT Period and were randomized into one of 3 treatment arms (1:1:1) with either Lu AF35700 10 mg/day, Lu AF35700 20 mg/day or to continue the treatment allocated in PC Period (olanzapine or risperidone) at the dose set at last visit of PC Period. This mean that approximately one third of the confirmed treatment-resistant patients were randomised back to the failed treatment used in the PC Period.

Data was not collected separately for the DBT Olanzapine and DBT Risperidone participants, and there was no intent to compare Lu AF35700 to each drug separately.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1098
Inclusion Criteria
  • The patient has schizophrenia, diagnosed according to DSM-5(TM) (Diagnostic and Statistical Manual of Mental Disorders) and confirmed by the Mini International Neuropsychiatric Interview for Schizophrenia and Psychotic Disorders
  • The patient is either an inpatient at a psychiatric setting or outpatient consulting a psychiatrist.
  • Patients should be treated with adequate dose(s) and agent(s) of antipsychotic treatment for at least 2 weeks prior to Screening
  • The patient has failed to show an adequate response in the level of psychotic symptoms despite at least one documented treatment trial with an adequate dose of an antipsychotic agent prescribed for an adequate time (at least lasting for 6 weeks) during 2 years prior to Screening. The failure to respond to the current antipsychotic treatment trial may be considered a retrospective failed treatment, if the patient was treated for 6 weeks with adequate dose(s) and agent(s)
  • The patient has a PANSS total score of ≥80 and a score of ≥4 on at least 2 of the following PANSS items (at Screening and at the first visit of Period A)
  • The patient has a CGI-S score of ≥4 at Screening and at the first visit of Period A
Exclusion Criteria
  • The patient has any current primary psychiatric disorder other than schizophrenia as assessed by the Mini International Neuropsychiatric Interview (MINI)
  • The patient is experiencing an acute exacerbation of his/her psychotic symptoms
  • The patient has not responded to treatment with clozapine

Other protocol defined inclusion and exclusion criteria may apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Prospective Confirmation (PC) PeriodRisperidoneSingle (patient)-blinded treatment period with risperidone or olanzapine for 6 weeks
Prospective Confirmation (PC) PeriodOlanzapineSingle (patient)-blinded treatment period with risperidone or olanzapine for 6 weeks
DBT Period, Continued treatment from PC PeriodOlanzapineEligible patients from PC Period (based on criteria to which investigator and patient are blinded), will be randomly assigned (1:1:1) double-blind treatment in DBT Period,10 weeks. Patients in this arm will continue with same the treatment and dose as at last visit of PC Period
DBT Period, Continued treatment from PC PeriodRisperidoneEligible patients from PC Period (based on criteria to which investigator and patient are blinded), will be randomly assigned (1:1:1) double-blind treatment in DBT Period,10 weeks. Patients in this arm will continue with same the treatment and dose as at last visit of PC Period
Double-blind Treatment (DBT) Period, Lu AF35700 10 mgLu AF35700Eligible patients from PC Period (based on criteria to which investigator and patient are blinded), will be randomly assigned (1:1:1) double-blind treatment in DBT Period, 10 weeks
DBT Period, Lu AF35700 20 mgLu AF35700Eligible patients from PC Period (based on criteria to which investigator and patient are blinded), will be randomly assigned (1:1:1) double-blind treatment in DBT Period, 10 weeks
Primary Outcome Measures
NameTimeMethod
Change From Randomization to Week 10 in Positive and Negative Syndrome Scale (PANSS) Total ScoreFrom Randomization to Week 10

PANSS total score administered by the investigator. It included 3 sub-scales with a total of 30 items that evaluated the Positive Symptoms subscale, the Negative Symptoms subscale, the General Psychopathology subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). PANSS total score was calculated as sum of all the items on the scale and ranged from 30 to 210. A higher score corresponded to a worse severity of schizophrenia.

Secondary Outcome Measures
NameTimeMethod
Response at Week 10, Defined as ≥20% Reduction in PANSS Total Score, PANSS (Positive and Negative Syndrome Scale) Total Score ≤70, CGI-S (Clinical Global Impression Scale - Severity of Illness) Score <4From Randomization to Week 10

PANSS total score administered by the investigator. It included 3 sub-scales with a total of 30 items that evaluated the Positive Symptoms subscale, the Negative Symptoms subscale, the General Psychopathology subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). PANSS total score was calculated as sum of all the items on the scale and ranged from 30 to 210. A higher score corresponded to a worse severity of schizophrenia. A reduction in score indicates improvement.

The Clinical Global Impression scale - severity of illness (CGI-S) is administered by the investigator. The patient is rated on a 7-point scale ranging from 1 (Normal - not at all ill) to 7 (among the most extremely ill patients). A reduction in scale indicates improvement.

Change From Randomization to Week 10 in PSP Total Personal and Social Performance (PSP) Total ScoreFrom Randomization to Week 10

PSP is a clinician-rated scale designed and validated to measure a patient's current level of social functioning. It consists of 4 items: socially useful activities, personal and social relationships, self-care, and disturbing and aggressive behaviours. Each items were assessed on a 6-point scale, from 1 (absent) to 6 (very severe). PSP score was calculated as sum of all the items on the scale and ranged from 4 to 100. A higher score represents more severe functional impairment.

Change From Randomization to Week 10 in Global Clinical Impression - Severity of Illness (CGI-S) ScoreFrom Randomization to Week 10

CGI-S provides the clinician's impression of the patient's current state of mental illness. The clinician uses his or her clinical experience of this patient population to rate the severity of the patient's current mental illness on a 7-point scale ranging from 1 (Normal - not at all ill) to 7 (among the most extremely ill patients). Higher scores indicate worsening.

Response at Week 10, Defined as ≥20% Reduction in Positive and Negative Syndrome Scale (PANSS) Total Score From RandomizationFrom Randomization to Week 10

PANSS total score administered by the investigator. It included 3 sub-scales with a total of 30 items that evaluated the Positive Symptoms subscale, the Negative Symptoms subscale, the General Psychopathology subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). PANSS total score was calculated as sum of all the items on the scale and ranged from 30 to 210. A higher score corresponded to a worse severity of schizophrenia. A reduction in score indicates improvement.

Response at Week 10, Defined as ≥30% Reduction in PANSS Total Score From RandomizationFrom Randomization to Week 10

Positive and Negative Syndrome Scale (PANSS) total score administered by the investigator. It included 3 sub-scales with a total of 30 items that evaluated the Positive Symptoms subscale, the Negative Symptoms subscale, the General Psychopathology subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). PANSS total score was calculated as sum of all the items on the scale and ranged from 30 to 210. A higher score corresponded to a worse severity of schizophrenia. A reduction in score indicates improvement.

Response at Week 10, Defined as ≥50% Reduction in Positive and Negative Syndrome Scale (PANSS) Total Score From RandomizationFrom Randomization to Week 10

PANSS total score administered by the investigator. It included 3 sub-scales with a total of 30 items that evaluated the Positive Symptoms subscale, the Negative Symptoms subscale, the General Psychopathology subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). PANSS total score was calculated as sum of all the items on the scale and ranged from 30 to 210. A higher score corresponded to a worse severity of schizophrenia. A reduction in score indicates improvement.

Response at Week 10, Defined as ≥40% Reduction in Positive and Negative Syndrome Scale (PANSS) Total Score From RandomizationFrom Randomization to Week 10

PANSS total score administered by the investigator. It included 3 sub-scales with a total of 30 items that evaluated the Positive Symptoms subscale, the Negative Symptoms subscale, the General Psychopathology subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). PANSS total score was calculated as sum of all the items on the scale and ranged from 30 to 210. A higher score corresponded to a worse severity of schizophrenia. A reduction in score indicates improvement.

Trial Locations

Locations (147)

BG1029

🇧🇬

Veliko Tŭrnovo, Bulgaria

MX1011

🇲🇽

Guadalajara, Mexico

MX1022

🇲🇽

Guadalajara, Mexico

RU1050

🇷🇺

Yaroslavl, Russian Federation

RS1008

🇷🇸

Belgrade, Serbia

RS1010

🇷🇸

Belgrade, Serbia

RS1011

🇷🇸

Kragujevac, Serbia

RS1016

🇷🇸

Kragujevac, Serbia

RS1003

🇷🇸

Nis, Serbia

RS1009

🇷🇸

Novi Knezevac, Serbia

SK1014

🇸🇰

Bratislava, Slovakia

SK1024

🇸🇰

Bratislava, Slovakia

SK1015

🇸🇰

Roznava, Slovakia

SK1025

🇸🇰

Svidnik, Slovakia

UA1019

🇺🇦

Dnipropetrovsk, Ukraine

UA1017

🇺🇦

Kharkiv, Ukraine

UA1022

🇺🇦

Kharkiv, Ukraine

UA1031

🇺🇦

Kharkiv, Ukraine

UA1035

🇺🇦

Kharkiv, Ukraine

UA1028

🇺🇦

Kherson, Ukraine

UA1029

🇺🇦

Kherson, Ukraine

UA1027

🇺🇦

Kiev, Ukraine

UA1033

🇺🇦

Lviv, Ukraine

UA1020

🇺🇦

Odessa, Ukraine

RO1024

🇷🇴

Bucuresti, Romania

MX1005

🇲🇽

Monterrey, Mexico

MX1007

🇲🇽

Monterrey, Mexico

MX1016

🇲🇽

Monterrey, Mexico

PL1026

🇵🇱

Gorlice, Poland

PL1027

🇵🇱

Lublin, Poland

MX1015

🇲🇽

Monterrey, Mexico

MX1018

🇲🇽

San Luis Potosi, Mexico

PL1025

🇵🇱

Bełchatów, Poland

PL1043

🇵🇱

Bialystok, Poland

PL1060

🇵🇱

Lodz, Poland

PL1058

🇵🇱

Pruszcz Gdanski, Poland

PL1059

🇵🇱

Torun, Poland

PL1051

🇵🇱

Wroclaw, Poland

RO1022

🇷🇴

Câmpulung, Romania

RO1025

🇷🇴

Sibiu, Romania

RO1004

🇷🇴

Târgu-Mureş, Romania

RU1006

🇷🇺

Moscow, Russian Federation

RU1051

🇷🇺

Moscow, Russian Federation

RU1023

🇷🇺

Saint Petersburg, Russian Federation

RU1028

🇷🇺

Saint Petersburg, Russian Federation

RU1030

🇷🇺

Saint Petersburg, Russian Federation

RU1056

🇷🇺

Saint Petersburg, Russian Federation

MX1024

🇲🇽

Durango, Mexico

MX1020

🇲🇽

Mexico, Mexico

BG1034

🇧🇬

Varna, Bulgaria

PL1061

🇵🇱

Pruszkow, Poland

RU1052

🇷🇺

Saint Petersburg, Russian Federation

RU1053

🇷🇺

Saint Petersburg, Russian Federation

RU1049

🇷🇺

St. Petersburg, Russian Federation

RS1012

🇷🇸

Belgrade, Serbia

RS1017

🇷🇸

Kragujevac, Serbia

UA1030

🇺🇦

Kiev, Ukraine

UA1032

🇺🇦

Odessa, Ukraine

UA1001

🇺🇦

Poltava, Ukraine

UA1036

🇺🇦

Vinnitsa, Ukraine

US1398

🇺🇸

Shreveport, Louisiana, United States

US1062

🇺🇸

Costa Mesa, California, United States

US1464

🇺🇸

Santa Ana, California, United States

CZ1038

🇨🇿

Praha, Czechia

CA1033

🇨🇦

Montréal, Canada

CZ1037

🇨🇿

Hostivice, Czechia

BG1028

🇧🇬

Kazanlak, Bulgaria

CA1039

🇨🇦

Québec, Canada

FI1030

🇫🇮

Kuopio, Finland

CZ1023

🇨🇿

Brno, Czechia

EE1016

🇪🇪

Pärnu, Estonia

FI1027

🇫🇮

Turku, Finland

MX1021

🇲🇽

Guadalajara, Mexico

CA1029

🇨🇦

Penticton, Canada

CZ1032

🇨🇿

Brno, Czechia

EE1007

🇪🇪

Tallinn, Estonia

FI1032

🇫🇮

Espoo, Finland

CZ1013

🇨🇿

Lnare, Czechia

CA1003

🇨🇦

Montréal, Canada

EE1017

🇪🇪

Viljandi, Estonia

ES1048

🇪🇸

Oviedo, Spain

ES1012

🇪🇸

Madrid, Spain

ES1049

🇪🇸

Zamora, Spain

RU1021

🇷🇺

Nikol'skoye, Gatchinckiy District, Russian Federation

RU1009

🇷🇺

Arkhangelsk, Russian Federation

ES1008

🇪🇸

Malaga, Spain

SK1026

🇸🇰

Zlate Moravce, Slovakia

ES1047

🇪🇸

Barcelona, Spain

US1130

🇺🇸

Miami, Florida, United States

US1018

🇺🇸

Bellflower, California, United States

US1041

🇺🇸

Cerritos, California, United States

US1104

🇺🇸

Garden Grove, California, United States

US1459

🇺🇸

Oceanside, California, United States

US1368

🇺🇸

Orange, California, United States

US1463

🇺🇸

Culver City, California, United States

US1118

🇺🇸

Glendale, California, United States

US1452

🇺🇸

Oceanside, California, United States

US1399

🇺🇸

Orange, California, United States

US1114

🇺🇸

National City, California, United States

US1384

🇺🇸

Sherman Oaks, California, United States

US1392

🇺🇸

Torrance, California, United States

US1253

🇺🇸

Jacksonville, Florida, United States

US1396

🇺🇸

Washington, District of Columbia, United States

US1395

🇺🇸

Bradenton, Florida, United States

US1318

🇺🇸

North Miami, Florida, United States

US1129

🇺🇸

North Miami, Florida, United States

US1402

🇺🇸

Oakland Park, Florida, United States

US1229

🇺🇸

Orange City, Florida, United States

US1403

🇺🇸

Atlanta, Georgia, United States

US1009

🇺🇸

Atlanta, Georgia, United States

US1442

🇺🇸

Decatur, Georgia, United States

US1423

🇺🇸

Hoffman Estates, Illinois, United States

US1046

🇺🇸

Chicago, Illinois, United States

US1086

🇺🇸

Flowood, Mississippi, United States

US1404

🇺🇸

Shreveport, Louisiana, United States

US1426

🇺🇸

Berlin, New Jersey, United States

US1444

🇺🇸

Las Vegas, Nevada, United States

US1394

🇺🇸

New York, New York, United States

US1454

🇺🇸

Marlton, New Jersey, United States

US1405

🇺🇸

Glen Oaks, New York, United States

US1244

🇺🇸

Jamaica, New York, United States

US1171

🇺🇸

Rochester, New York, United States

US1190

🇺🇸

Staten Island, New York, United States

US1390

🇺🇸

Charlotte, North Carolina, United States

US1441

🇺🇸

Hickory, North Carolina, United States

US1124

🇺🇸

Norristown, Pennsylvania, United States

US1065

🇺🇸

Dallas, Texas, United States

US1443

🇺🇸

Fort Worth, Texas, United States

BG1030

🇧🇬

Burgas, Bulgaria

BG1032

🇧🇬

Pazardzhik, Bulgaria

BG1003

🇧🇬

Lovech, Bulgaria

BG1008

🇧🇬

Plovdiv, Bulgaria

BG1024

🇧🇬

Sofia, Bulgaria

BG1026

🇧🇬

Sofia, Bulgaria

BG1033

🇧🇬

Varna, Bulgaria

BG1022

🇧🇬

Tserova Koria, Bulgaria

BG1027

🇧🇬

Vratsa, Bulgaria

CA1017

🇨🇦

Chatham, Canada

CA1034

🇨🇦

Kingston, Canada

RU1031

🇷🇺

Saint Petersburg, Russian Federation

US1416

🇺🇸

New York, New York, United States

RU1055

🇷🇺

Moscow, Russian Federation

US1391

🇺🇸

San Bernardino, California, United States

US1401

🇺🇸

Charlotte, North Carolina, United States

US1319

🇺🇸

Charleston, South Carolina, United States

US1453

🇺🇸

Tampa, Florida, United States

US1451

🇺🇸

Austin, Texas, United States

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