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Safety and Efficacy of Pyridoxal 5' -Phosphate in the Treatment of Tardive Dyskinesia

Primary Purpose

Tardive Dyskinesia

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Pyridoxal 5'-Phosphate
Placebo
Sponsored by
Medicure
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tardive Dyskinesia focused on measuring Tardive Dyskinesia, Schizophrenia, Pyridoxal 5'-phosphate

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must have signed an informed consent document indicating that they understand the purpose of the study, its objectives, and the expectations of participation in the study and that they agree to participate in the study.
  2. Meet current diagnostic criteria for Schizophrenia (Disorganized [295. 10], Paranoid [295.30], or Residual [295.60]), or Schizoaffective Disorder [295.70] as defined by the DSM-IV for at least 3 months before screening.
  3. Have been on a stable dose and regime of a LAI for at least 3 injection intervals or oral antipsychotic for at least 1 month prior to randomization and are expected to remain on this stable dose and regime throughout their participation in the study.
  4. Meet current diagnostic criteria for Neuroleptic Induced Tardive Dyskinesia [333.82] as defined by the DSM-IV.
  5. Scoring ≥3 (moderate) on item 8, the "severity of abnormal movements overall" section of the AIMS.
  6. Score ≥3 (moderate) on at least one item, or ≥2 (mild) on at least 2 items, and an overall total score of ≥5 on items 1 through 7 (facial and oral movements, extremity movements and trunk movements) sections of the AIMS.
  7. Female patients must be post-menopausal for at least 2 years or surgically sterile. Women of childbearing potential must be using or agree to use a reliable form of contraception before entry into and during participation in the study. Reliable contraception can include an oral or other hormonal contraceptive started at least 4 weeks prior to randomization, a barrier method such as condoms or a diaphragm used with spermicide, or an intrauterine device (IUD).
  8. Patients must be capable of administering study medication themselves or will have assistance with the administration of the study medication consistently available throughout the study.

Exclusion Criteria:

  1. Involuntarily committed to a psychiatric hospital or correctional facility.
  2. A primary active DSM-IV diagnosis or co-morbid Axis 1 diagnosis other than schizophrenia or schizoaffective disorder.
  3. PANSS Score > than 120 at the screening visit.
  4. Current medical diagnosis that which could confound the interpretation or evaluation of the indication under study (i.e. Parkinson's Disease, Huntington's Chorea, Muscular Dystrophy, Tourette's Syndrome).
  5. History of liver cirrhosis, chronic active hepatitis (known positive serum test within 6 months of enrollment) or severe liver dysfunction, or liver transaminase ≥3 times ULN at screening (or obtained within 30 days prior to screening visit)
  6. History of malignancy during the last 5 years.
  7. Pregnant or any woman of childbearing potential who is not using a reliable form of contraception (this can include an oral or other hormonal contraceptive started at least 4 weeks prior to randomization, a barrier method such as condoms or a diaphragm used with spermicide, or an intrauterine device (IUD)). Women who have been post-menopausal for at least two years or who have undergone surgical sterilization are considered to be not of childbearing potential.
  8. Any medical, such as unstable cardiovascular, respiratory, neurological, renal, hepatic, immunological or endocrine, or psychiatric condition which in the opinion of the investigator makes the patient an unsuitable candidate for the study.
  9. History of any pre-existing gastrointestinal narrowing or inability to swallow the oral study medication whole with the aid of water.
  10. Male and female patients with a BMI of ≥20.
  11. Significant, ongoing alcohol or drug dependency within 3 months before screening as defined by the DSM-IV (nicotine will not be exclusionary).
  12. Significant risk of suicide or violent behavior as clinically assessed by the investigator.
  13. Participation in any other investigational drug or device study within 30 days of randomization.
  14. Patients who have previously participated in this study.

Sites / Locations

  • Vancouver Island Health Authority
  • Centre for Addiction and Mental Health
  • Windsor Regional Hospital
  • Schizophrenia Research Foundation (SCARF) Mental Health Centre

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Pyridoxal 5'-Phosphate

Placebo

Arm Description

Pyridoxal 5'-Phosphate, enteric-coated 2x 250mgs po bid.

Placebo 2 pills, po bid.

Outcomes

Primary Outcome Measures

The primary outcome measure will be a reduction in the total AIMS score for items 1 through 7 (facial and oral movements, extremity movements and trunk movements) across treatment groups. .

Secondary Outcome Measures

An AIMS score reduction (items 1-7) across arms over course of study amongst completers; determine whether the proportion of responders differs between treatment arms; a reduction in the AIMS score, items 1 - 7 total, across treatment arms.

Full Information

First Posted
June 8, 2009
Last Updated
February 11, 2019
Sponsor
Medicure
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1. Study Identification

Unique Protocol Identification Number
NCT00917293
Brief Title
Safety and Efficacy of Pyridoxal 5' -Phosphate in the Treatment of Tardive Dyskinesia
Official Title
A Randomized, Double-Blind, Placebo-Controlled, Comparative Study to Evaluate the Safety and Efficacy of Pyridoxal 5' -Phosphate in the Treatment of Tardive Dyskinesia in Patients With Schizophrenia and Schizoaffective Disorders
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Terminated
Why Stopped
modified formulation under investigation
Study Start Date
May 2009 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medicure

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective is to assess the safety and effectiveness of Pyridoxal 5'-Phosphate on the reduction of expressed symptoms of tardive dyskinesia in patients with schizophrenia and schizoaffective disorders.
Detailed Description
This study will assess the effect of Pyridoxal 5'-Phosphate on the reduction of expressed symptoms of moderate to severe tardive dyskinesia in patients with schizophrenia and schizoaffective disorders who are on a stable dose, and regime, of either a long acting (i.e. depot/IM) or oral antipsychotic medication, as compared to placebo. Symptoms will be assessed through the administration and scoring of Abnormal Involuntary Movement Scale (AIMS), specifically on items 1 through 7 (facial and oral movements, extremity movements and trunk movements) at each visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tardive Dyskinesia
Keywords
Tardive Dyskinesia, Schizophrenia, Pyridoxal 5'-phosphate

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
53 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pyridoxal 5'-Phosphate
Arm Type
Experimental
Arm Description
Pyridoxal 5'-Phosphate, enteric-coated 2x 250mgs po bid.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo 2 pills, po bid.
Intervention Type
Drug
Intervention Name(s)
Pyridoxal 5'-Phosphate
Other Intervention Name(s)
Tardoxal
Intervention Description
Pyridoxal 5'-Phosphate 500mgs po bid for 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo 2 pills, po bid.
Primary Outcome Measure Information:
Title
The primary outcome measure will be a reduction in the total AIMS score for items 1 through 7 (facial and oral movements, extremity movements and trunk movements) across treatment groups. .
Time Frame
From baseline through to week 12
Secondary Outcome Measure Information:
Title
An AIMS score reduction (items 1-7) across arms over course of study amongst completers; determine whether the proportion of responders differs between treatment arms; a reduction in the AIMS score, items 1 - 7 total, across treatment arms.
Time Frame
From baseline through to Week 12 and Baseline compared to Week 12

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: Patients must have signed an informed consent document indicating that they understand the purpose of the study, its objectives, and the expectations of participation in the study and that they agree to participate in the study. Meet current diagnostic criteria for Schizophrenia (Disorganized [295. 10], Paranoid [295.30], or Residual [295.60]), or Schizoaffective Disorder [295.70] as defined by the DSM-IV for at least 3 months before screening. Have been on a stable dose and regime of a LAI for at least 3 injection intervals or oral antipsychotic for at least 1 month prior to randomization and are expected to remain on this stable dose and regime throughout their participation in the study. Meet current diagnostic criteria for Neuroleptic Induced Tardive Dyskinesia [333.82] as defined by the DSM-IV. Scoring ≥3 (moderate) on item 8, the "severity of abnormal movements overall" section of the AIMS. Score ≥3 (moderate) on at least one item, or ≥2 (mild) on at least 2 items, and an overall total score of ≥5 on items 1 through 7 (facial and oral movements, extremity movements and trunk movements) sections of the AIMS. Female patients must be post-menopausal for at least 2 years or surgically sterile. Women of childbearing potential must be using or agree to use a reliable form of contraception before entry into and during participation in the study. Reliable contraception can include an oral or other hormonal contraceptive started at least 4 weeks prior to randomization, a barrier method such as condoms or a diaphragm used with spermicide, or an intrauterine device (IUD). Patients must be capable of administering study medication themselves or will have assistance with the administration of the study medication consistently available throughout the study. Exclusion Criteria: Involuntarily committed to a psychiatric hospital or correctional facility. A primary active DSM-IV diagnosis or co-morbid Axis 1 diagnosis other than schizophrenia or schizoaffective disorder. PANSS Score > than 120 at the screening visit. Current medical diagnosis that which could confound the interpretation or evaluation of the indication under study (i.e. Parkinson's Disease, Huntington's Chorea, Muscular Dystrophy, Tourette's Syndrome). History of liver cirrhosis, chronic active hepatitis (known positive serum test within 6 months of enrollment) or severe liver dysfunction, or liver transaminase ≥3 times ULN at screening (or obtained within 30 days prior to screening visit) History of malignancy during the last 5 years. Pregnant or any woman of childbearing potential who is not using a reliable form of contraception (this can include an oral or other hormonal contraceptive started at least 4 weeks prior to randomization, a barrier method such as condoms or a diaphragm used with spermicide, or an intrauterine device (IUD)). Women who have been post-menopausal for at least two years or who have undergone surgical sterilization are considered to be not of childbearing potential. Any medical, such as unstable cardiovascular, respiratory, neurological, renal, hepatic, immunological or endocrine, or psychiatric condition which in the opinion of the investigator makes the patient an unsuitable candidate for the study. History of any pre-existing gastrointestinal narrowing or inability to swallow the oral study medication whole with the aid of water. Male and female patients with a BMI of ≥20. Significant, ongoing alcohol or drug dependency within 3 months before screening as defined by the DSM-IV (nicotine will not be exclusionary). Significant risk of suicide or violent behavior as clinically assessed by the investigator. Participation in any other investigational drug or device study within 30 days of randomization. Patients who have previously participated in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gary J. Remington, MD, PhD
Organizational Affiliation
Centre for Addiction and Mental Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Vancouver Island Health Authority
City
Victoria
State/Province
British Columbia
ZIP/Postal Code
V8R 4Z3
Country
Canada
Facility Name
Centre for Addiction and Mental Health
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5T 1R8
Country
Canada
Facility Name
Windsor Regional Hospital
City
Windsor
State/Province
Ontario
ZIP/Postal Code
N9C 3Z4
Country
Canada
Facility Name
Schizophrenia Research Foundation (SCARF) Mental Health Centre
City
Chennai
State/Province
TamilNadu
ZIP/Postal Code
600101
Country
India

12. IPD Sharing Statement

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Safety and Efficacy of Pyridoxal 5' -Phosphate in the Treatment of Tardive Dyskinesia

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