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Staccato Loxapine in Agitation (Proof of Concept)

Primary Purpose

Schizophrenia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Inhaled Placebo
Inhaled Loxapine 5 mg
Inhaled Loxapine 10 mg
Sponsored by
Alexza Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring Agitation, Schizophrenia

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Male and female patients between the ages of 18 to 65 years, inclusive. Patients who have met DSM-IV criteria for schizophrenia, schizophreniform disorder, or schizoaffective disorder. Patients who are judged to be clinically agitated at Baseline with a total score of ≥ 14 on the 5 items (poor impulse control, tension, hostility, uncooperativeness, and excitement) comprising the PANSS Excited Component (PEC). Patients who have a value of ≥ 4 (out of 7) on at least 1 of the 5 items on the PANSS Excited Component. Patients who read and understand English and provide written informed consent. Patients who are in good general health prior to study participation as determined by a detailed medical history, physical examination, 12-lead ECG, blood chemistry profile, hematology, urinalysis and in the opinion of the Principal Investigator. Female participants, if of child-bearing potential and sexually active, and male participants, if sexually active with a partner of child-bearing potential, who agree to use a medically acceptable and effective birth control method throughout the study and for one week following the end of the study. Medically acceptable methods of contraception that may be used by the participant and/or his/her partner include abstinence, birth control pills or patches, diaphragm with spermicide, intrauterine device (IUD), condom with foam or spermicide, vaginal spermicidal suppository, surgical sterilization and progestin implant or injection. Prohibited methods include: the rhythm method, withdrawal, condoms alone, or diaphragm alone. Exclusion Criteria: Patients with agitation caused by acute intoxication must be excluded. Positive identification of non-prescription drugs during urine screening excludes the subject. Patients treated with benzodiazepines or other hypnotics or oral or short-acting intramuscular antipsychotics within 4 hours prior to study drug administration must be excluded. Patients treated with injectable depot neuroleptics within one dose interval prior to study drug administration must be excluded. Patients with a history of allergic reactions to loxapine or amoxapine must be excluded. Female patients who have a positive pregnancy test at screening or are breastfeeding must be excluded. Patients who have Parkinson's disease, hydrocephalus, seizure disorder, or history of significant head trauma must be excluded. Patients with laboratory or ECG abnormalities considered clinically significant by the investigator or qualified designee that would have clinical implications for the patient's participation in the study must be excluded. Patients with serious and unstable illnesses including current hepatic, renal, gastroenterologic, respiratory, cardiovascular (including ischemic heart disease and congestive heart failure), endocrinologic, neurologic (including stroke, transient ischemic attack, subarachnoidal bleeding, brain tumor, encephalopathy, and meningitis), or hematologic disease must be excluded. Patients who have a history of acute or chronic pulmonary disease that precludes administration of Staccato Loxapine (asthma, bronchitis, emphysema) must be excluded. Patients who have received an investigational drug within 30 days prior to the current agitation episode must be excluded. Patients who are considered by the investigator, for any reason, to be an unsuitable candidate for receiving loxapine, or unable to use the inhalation device, must be excluded.

Sites / Locations

  • Pacific Clinical Research Medical Group, 1317 West Foothill Blvd, Suite 200,

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Inhaled Placebo

Inhaled Loxapine 5 mg

Inhaled Loxapine 10 mg

Arm Description

Inhaled Staccato Placebo, single dose

Inhaled Staccato Loxapine 5 mg, single dose

Inhaled Staccato Loxapine 10 mg, single dose

Outcomes

Primary Outcome Measures

PANSS-EC Change From Baseline
The Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) comprises 5 items associated with agitation: poor impulse control, tension, hostility, uncooperativeness, and excitement; each scored 1 (min) to 7 (max). The PANSS-EC, the sum of these 5 subscales, thus ranges from 5 to 35. Individuals were eligible if they had a PANSS-EC of ≥14 (out of 35) and a score ≥4 (out of 7) on at least 1 of the 5 items.

Secondary Outcome Measures

BARS Change From Baseline After Drug Treatment
Change from baseline on the Behavioral Activity Rating Scale (BARS) ranging from 1 to 7 where: 1 = difficult or unable to rouse, 2 = asleep but responds normally to verbal or physical contact, 3 = drowsy, appears sedated, 4 = quiet, and awake (normal level of activity), 5 = signs of overt (physical or verbal) activity, calms down with instructions, 6 = extremely or continuously active, not requiring restraint, 7 = violent, requires restraint.
Clinical Global Impressions-Improvement Scale (CGI-I) After Drug Administration
Clinical Global Impression- Improvement (CGI-I) scores ranged from 1 to 7: 0=not assessed (missing), 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, 7=very much worse.
CGI-I Responders
Frequency of response based on the CGI-I (defined as achieving a CGI-I score of 1 or 2 at 2 hours after administration of the inhalation)

Full Information

First Posted
August 25, 2006
Last Updated
May 30, 2017
Sponsor
Alexza Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00369577
Brief Title
Staccato Loxapine in Agitation (Proof of Concept)
Official Title
A Multi-center, Randomized, Double-blind, Placebo-controlled, Single Dose Efficacy and Safety Study of StaccatoTM Loxapine for Inhalation in Schizophrenic Patients With Agitation.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2013
Overall Recruitment Status
Completed
Study Start Date
August 2006 (undefined)
Primary Completion Date
January 2007 (Actual)
Study Completion Date
January 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alexza Pharmaceuticals, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess efficacy and safety of Staccato Loxapine in the treatment of acute agitation in schizophrenic patients. The study will be conducted in 120 agitated schizophrenic patients - either newly admitted to a hospital setting or a research unit for acute agitation or already in hospital for chronic underlying conditions. Patients meeting entry criteria will be randomized to one of two doses of Staccato Loxapine or to Staccato Placebo. Following administration of study drug, assessment of agitation state will be conducted at serial time points using standard agitation scales over a 24 hour period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia
Keywords
Agitation, Schizophrenia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
129 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Inhaled Placebo
Arm Type
Placebo Comparator
Arm Description
Inhaled Staccato Placebo, single dose
Arm Title
Inhaled Loxapine 5 mg
Arm Type
Experimental
Arm Description
Inhaled Staccato Loxapine 5 mg, single dose
Arm Title
Inhaled Loxapine 10 mg
Arm Type
Experimental
Arm Description
Inhaled Staccato Loxapine 10 mg, single dose
Intervention Type
Drug
Intervention Name(s)
Inhaled Placebo
Other Intervention Name(s)
Staccato Loxapine Placebo
Intervention Description
Inhaled Placebo, single dose
Intervention Type
Drug
Intervention Name(s)
Inhaled Loxapine 5 mg
Other Intervention Name(s)
Inhaled Staccato Loxapine 5 mg, ADASUVE 5 mg
Intervention Description
Inhaled Staccato Loxapine 5 mg, single dose
Intervention Type
Drug
Intervention Name(s)
Inhaled Loxapine 10 mg
Other Intervention Name(s)
Inhaled Staccato Loxapine 10 mg, ADASUVE 10 mg
Intervention Description
Inhaled Staccato Loxapine 10 mg, single dose
Primary Outcome Measure Information:
Title
PANSS-EC Change From Baseline
Description
The Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) comprises 5 items associated with agitation: poor impulse control, tension, hostility, uncooperativeness, and excitement; each scored 1 (min) to 7 (max). The PANSS-EC, the sum of these 5 subscales, thus ranges from 5 to 35. Individuals were eligible if they had a PANSS-EC of ≥14 (out of 35) and a score ≥4 (out of 7) on at least 1 of the 5 items.
Time Frame
2 hours
Secondary Outcome Measure Information:
Title
BARS Change From Baseline After Drug Treatment
Description
Change from baseline on the Behavioral Activity Rating Scale (BARS) ranging from 1 to 7 where: 1 = difficult or unable to rouse, 2 = asleep but responds normally to verbal or physical contact, 3 = drowsy, appears sedated, 4 = quiet, and awake (normal level of activity), 5 = signs of overt (physical or verbal) activity, calms down with instructions, 6 = extremely or continuously active, not requiring restraint, 7 = violent, requires restraint.
Time Frame
2 hours
Title
Clinical Global Impressions-Improvement Scale (CGI-I) After Drug Administration
Description
Clinical Global Impression- Improvement (CGI-I) scores ranged from 1 to 7: 0=not assessed (missing), 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, 7=very much worse.
Time Frame
2 hours
Title
CGI-I Responders
Description
Frequency of response based on the CGI-I (defined as achieving a CGI-I score of 1 or 2 at 2 hours after administration of the inhalation)
Time Frame
2 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients between the ages of 18 to 65 years, inclusive. Patients who have met DSM-IV criteria for schizophrenia, schizophreniform disorder, or schizoaffective disorder. Patients who are judged to be clinically agitated at Baseline with a total score of ≥ 14 on the 5 items (poor impulse control, tension, hostility, uncooperativeness, and excitement) comprising the PANSS Excited Component (PEC). Patients who have a value of ≥ 4 (out of 7) on at least 1 of the 5 items on the PANSS Excited Component. Patients who read and understand English and provide written informed consent. Patients who are in good general health prior to study participation as determined by a detailed medical history, physical examination, 12-lead ECG, blood chemistry profile, hematology, urinalysis and in the opinion of the Principal Investigator. Female participants, if of child-bearing potential and sexually active, and male participants, if sexually active with a partner of child-bearing potential, who agree to use a medically acceptable and effective birth control method throughout the study and for one week following the end of the study. Medically acceptable methods of contraception that may be used by the participant and/or his/her partner include abstinence, birth control pills or patches, diaphragm with spermicide, intrauterine device (IUD), condom with foam or spermicide, vaginal spermicidal suppository, surgical sterilization and progestin implant or injection. Prohibited methods include: the rhythm method, withdrawal, condoms alone, or diaphragm alone. Exclusion Criteria: Patients with agitation caused by acute intoxication must be excluded. Positive identification of non-prescription drugs during urine screening excludes the subject. Patients treated with benzodiazepines or other hypnotics or oral or short-acting intramuscular antipsychotics within 4 hours prior to study drug administration must be excluded. Patients treated with injectable depot neuroleptics within one dose interval prior to study drug administration must be excluded. Patients with a history of allergic reactions to loxapine or amoxapine must be excluded. Female patients who have a positive pregnancy test at screening or are breastfeeding must be excluded. Patients who have Parkinson's disease, hydrocephalus, seizure disorder, or history of significant head trauma must be excluded. Patients with laboratory or ECG abnormalities considered clinically significant by the investigator or qualified designee that would have clinical implications for the patient's participation in the study must be excluded. Patients with serious and unstable illnesses including current hepatic, renal, gastroenterologic, respiratory, cardiovascular (including ischemic heart disease and congestive heart failure), endocrinologic, neurologic (including stroke, transient ischemic attack, subarachnoidal bleeding, brain tumor, encephalopathy, and meningitis), or hematologic disease must be excluded. Patients who have a history of acute or chronic pulmonary disease that precludes administration of Staccato Loxapine (asthma, bronchitis, emphysema) must be excluded. Patients who have received an investigational drug within 30 days prior to the current agitation episode must be excluded. Patients who are considered by the investigator, for any reason, to be an unsuitable candidate for receiving loxapine, or unable to use the inhalation device, must be excluded.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Zimbroff, MD
Organizational Affiliation
Pacific Clinical Research Medical Group
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pacific Clinical Research Medical Group, 1317 West Foothill Blvd, Suite 200,
City
Upland
State/Province
California
ZIP/Postal Code
91786
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
IPD submitted to regulatory authorities. Others may contact Alexza Pharmaceuticals, Inc. Please send your request to ClinicalTrialsInfo@alexza.com
Citations:
PubMed Identifier
21294997
Citation
Allen MH, Feifel D, Lesem MD, Zimbroff DL, Ross R, Munzar P, Spyker DA, Cassella JV. Efficacy and safety of loxapine for inhalation in the treatment of agitation in patients with schizophrenia: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2011 Oct;72(10):1313-21. doi: 10.4088/JCP.10m06011yel.
Results Reference
result

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Staccato Loxapine in Agitation (Proof of Concept)

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