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Tolerability, Safety and Efficacy of Flexibly Dosed Paliperidone ER in Patients With Schizophrenia

Phase 4
Completed
Conditions
Schizophrenia
Interventions
Registration Number
NCT01724359
Lead Sponsor
Janssen-Cilag, S.A.
Brief Summary

The purpose of this study is to evaluate efficacy, safety and tolerability of flexible, once-daily doses of paliperidone extended-release (ER) in patients with schizophrenia from Argentina and Colombia that previously failed treatment with other antipsychotic agents.

Detailed Description

This is a single arm (one group of patients), open-label (all people know the identity of the intervention) multicenter 6-month study. Throughout the study flexible dosing of paliperidone ER in a range of 3 to 12 mg/day may be used. Flexible dosing will allow investigators to adjust the dosage of each patient based on the individual needs. Patients will receive 3, 6, 9 or 12 mg of paliperidone ER once daily for 6 months. The tablets will be taken orally. Adjustment of the dosage will be done at the investigator's discretion, based on the individual patient's clinical response and tolerability to the study drug.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
95
Inclusion Criteria
  • Patient meets the criteria for schizophrenia
  • Patient is previously non-acute and has been given an adequate dose of an appropriate oral antipsychotic for an adequate period of time prior to enrollment, but previous treatment is considered unsuccessful due to one or more of the following reasons: lack of efficacy, lack of tolerability or safety, lack of compliance and/or other reasons to switch to another antipsychotic medication
  • Patient is healthy on the basis of a physical examination and vital signs at screening
  • Women must be postmenopausal for at least 1 year, surgically sterile, abstinent, or, if sexually active, agree to practice an effective method of birth control before entry and throughout the study
Exclusion Criteria
  • Patients on clozapine, any conventional depot neuroleptic or risperidone long-acting injections during the last 3 months
  • Patients with serious unstable medical condition, including known clinically relevant laboratory abnormalities
  • Patients with history or current symptoms of tardive dyskinesia and neuroleptic malignant syndrome
  • Patients judged to be at high risk for adverse events, violence, or self-harm
  • Patients with known hypersensitivity to paliperidone ER or to risperidone
  • Patients with a current use or known history (over the past 6 months) of substance dependence

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Paliperidone ERPaliperidone ER-
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) ScoreBaseline, Week 26

The PANSS is a 30-item scale designed to assess various symptoms of schizophrenia. The 30 symptoms are rated on a 7-point scale that ranges from 1 (absent) to 7 (extreme psychopathology). The PANSS total score consists of the sum of all 30 PANSS items and ranges from 30 to 210. Higher scores indicate worsening.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) - Positive Subscale ScoreBaseline, Week 26

The PANSS Positive Subscale assesses seven positive-symptoms of schizophrenia. Positive symptoms refer to an excess or distortion of normal functions. The symptoms are rated on a 7-point scale, with a range of 7 (absent) to 49 (extreme psychopathology).

Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) - Negative Subscale ScoreBaseline, Week 26

The PANSS Negative Subscale assesses seven negative-symptoms of schizophrenia. Negative symptoms represent a diminution or loss of normal functions. The symptoms are rated on a 7-point scale, with a range of 7 (absent) to 49 (extreme psychopathology).

Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) - General Psychopathology Subscale ScoreBaseline, Week 26

The PANSS General Psychopathology Subscale Score assesses 16 general psychopathology symptoms. The symptoms are rated on a 7-point scale, with a range of 16 (absent) to 112 (extreme psychopathology).

Clinical Global Impression-Severity (CGIS)Baseline, Week 26

The CGI-S rating scale is a 7 point global assessment that measures the clinician's impression of the severity of illness exhibited by a patient. A rating of 1 is equivalent to "Normal, not at all ill" and a rating of 7 is equivalent to "Among the most extremely ill patients". Higher scores indicate worsening.

Personal and Social Performance (PSP) ScaleBaseline, Week 26

This PSP assesses the degree of a patient's dysfunction within 4 domains of behavior: socially useful activities, personal and social relationships, self-care, and disturbing and aggressive behavior. The score ranges from 1 to 100, divided into 10 equal intervals to rate the degree of difficulty (i, absent to vi, very severe) in each of the 4 domains. Based on the four domains there will be one total score. Patients with a score of 71 to 100 have a mild degree of difficulty; from 31 to 70, varying degrees of disability; =\< 30, functioning so poorly as to require intensive supervision.

Health Status as Measured by Self-rated Health Status Survey SF-36Baseline, Week 26

The SF-36 is designed to examine a person's perceived health status. The SF-36 includes one multi-item scale measuring eight health concepts: vitality, physical functioning, bodily pain, general health perceptions, physical role-, emotional role-, social role functioning, and mental health. Answers to each question are scored and summed to produce raw scale scores for each health concept which are then transformed to a 0 - 100 scale, a high score defining a more favorable health state. An aggregate summary measure is calculated by averaging the scores from the eight health concepts.

Sleep Evaluation ScaleBaseline, Week 26

This self-administered scale rates the quality of sleep. Patients will indicate on an 11-point scale how well they have slept in the previous 7 days, from 0 (very badly) to 10 (very well).

Daytime Drowsiness Evaluation ScaleBaseline, Week 26

This self-administered scale rates the daytime drowsiness. Patients will indicate on an 11-point scale how often they have felt drowsy within the previous 7 days, from 0 (not at all) to 10 (all the time).

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