IQVIA has been granted permission by the Subject Expert Committee (SEC) under the Central Drug Standard Control Organisation (CDSCO) to conduct a Phase III clinical trial of lumateperone for treating bipolar depression in pediatric patients. This decision follows IQVIA's presentation of the Phase III clinical study protocol ITI-007-421, Amendment 1, dated March 15, 2024, with an India-specific amendment dated October 24, 2024.
Lumateperone's Novel Mechanism of Action
Lumateperone distinguishes itself from other second-generation antipsychotics through its unique target profile and dopamine D2 receptor occupancy. It acts as a partial agonist at presynaptic dopamine (D2) receptors, reducing presynaptic dopamine release, and as an antagonist at postsynaptic dopamine (D2) receptors. This dual action allows lumateperone to efficiently modulate dopamine signaling.
Furthermore, lumateperone targets dopamine (D1) receptors, and D1 activation leads to increased glutamatergic N-methyl-D-aspartate (NMDA) GluN2B receptor phosphorylation. This is particularly relevant as NMDA-mediated glutamate signaling is often impaired in patients with schizophrenia. Lumateperone also modulates serotonin by inhibiting serotonin transporters (SERT) and acting as a 5-HT2A receptor antagonist.
SEC Review and Recommendation
The SEC for Neurology and Psychiatry reviewed the Phase III clinical study protocol ITI-007-421 during a meeting on December 12, 2024. Following detailed deliberation, the committee recommended granting permission for IQVIA to conduct the trial as presented. This multicenter study aims to evaluate the efficacy and safety of lumateperone in the treatment of bipolar depression in pediatric patients, potentially offering a new therapeutic option for this vulnerable population.
