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Study of EVP-6124 (Alpha-7 nAChR) as an Adjunctive Pro-Cognitive Treatment in Schizophrenia Subjects on Chronic Stable Atypical Antipsychotic Therapy

Primary Purpose

Schizophrenia, Impaired Cognition

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
EVP-6124
Placebo
Sponsored by
FORUM Pharmaceuticals Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring Schizophrenia, Cognition, Cognition Impairment, Alpha-7 nAChR

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 18 to 50 years of age, inclusive
  • Signed informed consent, indicating that the subject understands the purpose of and procedures required for the study, before the initiation of any study specific procedures. Subjects who are unable to provide informed consent will not be included in the study.
  • Resides in a stable living situation, according to the investigator's judgment, and must have an identified informant who should be consistent throughout the study. If possible, the informant should accompany the subject or be available for in person ratings at the screening, baseline (Day 1), and final study visits. In person informant ratings on all relevant study visits are preferred whenever possible. However, if the informant is not available for in person ratings, telephone interview is acceptable. The informant must be available for a telephone interview throughout the study at all visits. As long as both the informant visit and subject visit are within the study visit windows, it is not necessary that they occur on the same day. The informant must interact with the subject at least 2 times a week.
  • Diagnosis of Schizophrenia of at least 3 years duration. This diagnosis can be established utilizing the SCID-I, direct clinical assessments, family, informants, and confirmation of diagnosis from clinical sources. These may include medical records, confirmation of diagnosis by treating clinician through telephone contact, or written confirmation from treating clinic. If the listed sources are not available, other sources of diagnostic confirmation may also be acceptable after discussion with the medical monitor.
  • Treated with atypical antipsychotic drug (in any approved dosage form) other than Clozapine at a stable dose for at least 8 weeks prior to screening and be clinically stable; the subject must remain clinically stable (in the opinion of the principal investigator) through randomization. The use of up to 2 atypical antipsychotic drugs is permitted, as long as in the opinion of the investigator, the second medication is not required to control treatment-resistant or intractable psychotic symptoms. No subject will be washed off antipsychotic therapy to become eligible for this study.
  • Schizophrenia clinical symptom burden severity defined by the following: a Brief Psychiatric Rating Scale (BPRS) Conceptual Disorganization item score ≤ 4; and a BPRS Hallucinatory Behavior item score ≤ 5, or an Unusual Thought Content item score ≤ 5. Either Hallucinatory Behavior or Unusual Thought Content, but not both, may have a score of 6 (but not > 6).
  • Simpson-Angus Scale (SAS) total score ≤ 6
  • Calgary Depression Scale for Schizophrenia (CDSS) total score ≤ 10
  • General health status acceptable for participation in a 26-week clinical study
  • Fertile, sexually active subjects (men and women) must use an effective method of contraception during the study
  • Fluency (oral and written) in the language in which the standardized tests will be administered
  • The ability to refrain from using any tobacco or other nicotine-containing products for at least 30 minutes before any cognitive testing

Exclusion Criteria:

  • Hospitalization within 12 weeks before screening or during the screening period, or change of antipsychotic medication or dose within 8 weeks before screening or during the screening period.
  • Participation in another therapeutic (medication administration) clinical study within the past 2 months.
  • Psychiatric hospitalization or incarcerations due to breakthrough symptoms or acute exacerbations for a period of 3 months before screening. Subjects with a recent "social" hospitalization or incarceration may be entered into screening after consultation with the medical monitor
  • Likelihood, in the opinion of the investigator, that either the subject or informant will be unable to complete a 26-week study
  • Treatment with prohibited antipsychotic drug, and/or treatment with more than 2 permitted antipsychotic drugs. Treatment with a first-generation antipsychotic drug (typical antipsychotic) is prohibited unless it is administered at a low dose after discussion with the medical monitor
  • Current treatment with any anticholinergic agent
  • Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria met for alcohol abuse within the past 3 months or substance abuse (other than nicotine) within the last 6 months before screening
  • Significant suicide risk as defined by 1) suicidal ideation as endorsed on items 4 or 5 of the Columbia-Suicide Severity Rating Scale (C-SSRS) within the past year; 2) suicidal behavior detected by the C-SSRS during the past 2 years, or 3) psychiatric interview and examination
  • Stroke within 6 months before screening, history of brain tumor, subdural hematoma, or other clinically significant neurological condition, head trauma with loss of consciousness within 12 months before screening
  • Monoamine oxidase inhibitor antidepressants or tricyclic medications used in antidepressant doses are excluded. Other antidepressant medications are allowed if the subject has been treated with a stable dose for at least 3 months before screening
  • Immunosuppressants, mood stabilizers, chronic use of a sedative hypnotic drug, chronic intake of clinically significant doses of opioid containing analgesics or any current methadone treatment all in the judgment of the investigator may be permitted depending on the circumstance
  • Use of Central Nervous System(CNS) stimulants
  • Nicotine therapy (including patches), varenicline (Chantix), or similar therapeutic agent within the last six months before screening
  • Use of a benzodiazepine medication is allowed if the subject has not had a change in medication or dose for at least 3 months. For subjects prescribed benzodiazepines, short-acting benzodiazepines are to be used whenever possible. Use of longer-acting benzodiazepines may be acceptable if prior authorization is obtained from the medical monitor. When possible, benzodiazepines should not be administered within 3 hours before cognitive testing. The use of more than one sedative-hypnotic medication is not allowed.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

EVP-6124, Placebo

EVP-6124, low dose

EVP-6124, high dose

Arm Description

Placebo, Tablet, Once Daily, Day -14 through Day 182

low dose, Tablet, Once Daily, Day 1 through Day 182

high dose, Tablet, Once Daily, Day 1 through Day 182

Outcomes

Primary Outcome Measures

Change from Baseline in the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) to Day 182
Change from Baseline in the Schizophrenia Cognition Rating Scale (SCoRs) to Day 182
Safety and Tolerability of EVP-6124 or Placebo in Subjects with Schizophrenia
All adverse experiences spontaneously reported by subject and/or observed by investigator and repeated clinical evaluation of physical examinations, vital signs, 12-lead ECG (electrocardiogram), ambulatory ECG, and laboratory tests (hematology/blood/chemistry/urinalysis)

Secondary Outcome Measures

Change from Baseline in the Positive and Negative Symptom Scale (PANSS) to Day 182
Change from Baseline in the Clinical Global Impression-Severity (CGI-S) to Day 182
Change from Baseline in the Clinical Global Impression Change Scale (CGI-C) to Day 182
Change from Baseline in the EuroQOL-5D (EQ-5D) to Day 182

Full Information

First Posted
October 19, 2012
Last Updated
May 2, 2016
Sponsor
FORUM Pharmaceuticals Inc
Collaborators
Syneos Health, NeuroCog Trials, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01716975
Brief Title
Study of EVP-6124 (Alpha-7 nAChR) as an Adjunctive Pro-Cognitive Treatment in Schizophrenia Subjects on Chronic Stable Atypical Antipsychotic Therapy
Official Title
A Randomized, Double-blind, Placebo-controlled, Parallel, 26-Week, Phase 3 Study of 2 Doses of an Alpha-7 Nicotinic Acetylcholine Receptor Agonist (EVP-6124) or Placebo as an Adjunctive Pro-cognitive Treatment in Schizophrenia Subjects on Chronic Stable Atypical Antipsychotic Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
June 2015
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
February 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
FORUM Pharmaceuticals Inc
Collaborators
Syneos Health, NeuroCog Trials, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine if EVP-6124 (an alpha-7 nAChR agonist) enhances the cognitive abilities of subjects with Schizophrenia who are also taking stable antipsychotic therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia, Impaired Cognition
Keywords
Schizophrenia, Cognition, Cognition Impairment, Alpha-7 nAChR

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
767 (Actual)

8. Arms, Groups, and Interventions

Arm Title
EVP-6124, Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo, Tablet, Once Daily, Day -14 through Day 182
Arm Title
EVP-6124, low dose
Arm Type
Experimental
Arm Description
low dose, Tablet, Once Daily, Day 1 through Day 182
Arm Title
EVP-6124, high dose
Arm Type
Experimental
Arm Description
high dose, Tablet, Once Daily, Day 1 through Day 182
Intervention Type
Drug
Intervention Name(s)
EVP-6124
Intervention Description
Arms 1, 2
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Arm 3
Primary Outcome Measure Information:
Title
Change from Baseline in the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) to Day 182
Time Frame
Baseline to Day 182 or Early Termination
Title
Change from Baseline in the Schizophrenia Cognition Rating Scale (SCoRs) to Day 182
Time Frame
Baseline to Day 182 or Early Termination
Title
Safety and Tolerability of EVP-6124 or Placebo in Subjects with Schizophrenia
Description
All adverse experiences spontaneously reported by subject and/or observed by investigator and repeated clinical evaluation of physical examinations, vital signs, 12-lead ECG (electrocardiogram), ambulatory ECG, and laboratory tests (hematology/blood/chemistry/urinalysis)
Time Frame
Screening (Day -42 to Day -15) to Day 182 or Early Terminiation
Secondary Outcome Measure Information:
Title
Change from Baseline in the Positive and Negative Symptom Scale (PANSS) to Day 182
Time Frame
Baseline to Day 182 or Early Termination
Title
Change from Baseline in the Clinical Global Impression-Severity (CGI-S) to Day 182
Time Frame
Baseline to Day 182 or Early Termination
Title
Change from Baseline in the Clinical Global Impression Change Scale (CGI-C) to Day 182
Time Frame
Baseline to Day 182 or Early Termination
Title
Change from Baseline in the EuroQOL-5D (EQ-5D) to Day 182
Time Frame
Baseline to Day 182 or Early Termination

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18 to 50 years of age, inclusive Signed informed consent, indicating that the subject understands the purpose of and procedures required for the study, before the initiation of any study specific procedures. Subjects who are unable to provide informed consent will not be included in the study. Resides in a stable living situation, according to the investigator's judgment, and must have an identified informant who should be consistent throughout the study. If possible, the informant should accompany the subject or be available for in person ratings at the screening, baseline (Day 1), and final study visits. In person informant ratings on all relevant study visits are preferred whenever possible. However, if the informant is not available for in person ratings, telephone interview is acceptable. The informant must be available for a telephone interview throughout the study at all visits. As long as both the informant visit and subject visit are within the study visit windows, it is not necessary that they occur on the same day. The informant must interact with the subject at least 2 times a week. Diagnosis of Schizophrenia of at least 3 years duration. This diagnosis can be established utilizing the SCID-I, direct clinical assessments, family, informants, and confirmation of diagnosis from clinical sources. These may include medical records, confirmation of diagnosis by treating clinician through telephone contact, or written confirmation from treating clinic. If the listed sources are not available, other sources of diagnostic confirmation may also be acceptable after discussion with the medical monitor. Treated with atypical antipsychotic drug (in any approved dosage form) other than Clozapine at a stable dose for at least 8 weeks prior to screening and be clinically stable; the subject must remain clinically stable (in the opinion of the principal investigator) through randomization. The use of up to 2 atypical antipsychotic drugs is permitted, as long as in the opinion of the investigator, the second medication is not required to control treatment-resistant or intractable psychotic symptoms. No subject will be washed off antipsychotic therapy to become eligible for this study. Schizophrenia clinical symptom burden severity defined by the following: a Brief Psychiatric Rating Scale (BPRS) Conceptual Disorganization item score ≤ 4; and a BPRS Hallucinatory Behavior item score ≤ 5, or an Unusual Thought Content item score ≤ 5. Either Hallucinatory Behavior or Unusual Thought Content, but not both, may have a score of 6 (but not > 6). Simpson-Angus Scale (SAS) total score ≤ 6 Calgary Depression Scale for Schizophrenia (CDSS) total score ≤ 10 General health status acceptable for participation in a 26-week clinical study Fertile, sexually active subjects (men and women) must use an effective method of contraception during the study Fluency (oral and written) in the language in which the standardized tests will be administered The ability to refrain from using any tobacco or other nicotine-containing products for at least 30 minutes before any cognitive testing Exclusion Criteria: Hospitalization within 12 weeks before screening or during the screening period, or change of antipsychotic medication or dose within 8 weeks before screening or during the screening period. Participation in another therapeutic (medication administration) clinical study within the past 2 months. Psychiatric hospitalization or incarcerations due to breakthrough symptoms or acute exacerbations for a period of 3 months before screening. Subjects with a recent "social" hospitalization or incarceration may be entered into screening after consultation with the medical monitor Likelihood, in the opinion of the investigator, that either the subject or informant will be unable to complete a 26-week study Treatment with prohibited antipsychotic drug, and/or treatment with more than 2 permitted antipsychotic drugs. Treatment with a first-generation antipsychotic drug (typical antipsychotic) is prohibited unless it is administered at a low dose after discussion with the medical monitor Current treatment with any anticholinergic agent Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria met for alcohol abuse within the past 3 months or substance abuse (other than nicotine) within the last 6 months before screening Significant suicide risk as defined by 1) suicidal ideation as endorsed on items 4 or 5 of the Columbia-Suicide Severity Rating Scale (C-SSRS) within the past year; 2) suicidal behavior detected by the C-SSRS during the past 2 years, or 3) psychiatric interview and examination Stroke within 6 months before screening, history of brain tumor, subdural hematoma, or other clinically significant neurological condition, head trauma with loss of consciousness within 12 months before screening Monoamine oxidase inhibitor antidepressants or tricyclic medications used in antidepressant doses are excluded. Other antidepressant medications are allowed if the subject has been treated with a stable dose for at least 3 months before screening Immunosuppressants, mood stabilizers, chronic use of a sedative hypnotic drug, chronic intake of clinically significant doses of opioid containing analgesics or any current methadone treatment all in the judgment of the investigator may be permitted depending on the circumstance Use of Central Nervous System(CNS) stimulants Nicotine therapy (including patches), varenicline (Chantix), or similar therapeutic agent within the last six months before screening Use of a benzodiazepine medication is allowed if the subject has not had a change in medication or dose for at least 3 months. For subjects prescribed benzodiazepines, short-acting benzodiazepines are to be used whenever possible. Use of longer-acting benzodiazepines may be acceptable if prior authorization is obtained from the medical monitor. When possible, benzodiazepines should not be administered within 3 hours before cognitive testing. The use of more than one sedative-hypnotic medication is not allowed.
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Phoenixville
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Cerritos
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Miami
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North Miami
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Chicago
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Buenos Aires
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Argentina
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Rosario
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Santa Fe
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Mendoza
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Adelaide
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Mt. Claremont
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Salvader
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BA
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Brazil
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Belo Horizonte
State/Province
MG
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Brazil
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Curitiba
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Parana
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Brazil
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Medellin
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Antioquia
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Colombia
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Barranquilla
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Atlantico
Country
Colombia
City
Pereira
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Risaralda
Country
Colombia
City
Bogota D.C.
Country
Colombia
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Firenze
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FL
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Italy
City
Milan
State/Province
MI
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Italy
City
Ban
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Barl
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Catania
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Italy
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Lucca
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Italy
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Milano
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Pisa
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Roma
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Monterrey
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Nuevo Leon
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San Luis Potosi
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Belchatow
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Chelmno
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Karakow
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Kielce
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Kotarbinskiego
Country
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Sosnowiec
Country
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City
Torun
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Wroclaw
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City
Campulung
State/Province
Arges
Country
Romania
City
Oradea
State/Province
Bihor
Country
Romania
City
Cluj-Napoca
State/Province
Cluj
Country
Romania
City
Palazu-Mare
State/Province
Constanta
Country
Romania
City
Targu-Mures
State/Province
Munes
Country
Romania
City
Bucuresti
State/Province
Sector 4
Country
Romania
City
Iasi
Country
Romania
City
Saint-Petersburg
State/Province
Leningrad
Country
Russian Federation
City
Smolensk
State/Province
Smolensk region
Country
Russian Federation
City
Moscow
Country
Russian Federation
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Saint-Petersburg
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Russian Federation
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Samara
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vil. Stepanivka
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Kherson
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Cambridge
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United Kingdom
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Newcastle-upon-Tyne
State/Province
Tyne and Wear
Country
United Kingdom
City
Exeter
Country
United Kingdom
City
London
Country
United Kingdom

12. IPD Sharing Statement

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Study of EVP-6124 (Alpha-7 nAChR) as an Adjunctive Pro-Cognitive Treatment in Schizophrenia Subjects on Chronic Stable Atypical Antipsychotic Therapy

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