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RCT of Methotrexate Added to Treatment As Usual in Schizophrenia (RECOVERY)

Primary Purpose

Schizophrenia, Schizoaffective Disorder, Schizophreniform Disorder

Status
Completed
Phase
Phase 1
Locations
Pakistan
Study Type
Interventional
Intervention
Methotrexate
Sponsored by
Pakistan Institute of Living and Learning
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring Schizophrenia, Anti-Inflammatory, Methotrexate, Psychosis Not Otherwise Specified

Eligibility Criteria

18 Years - 35 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed informed consent, indicating that the subject understood the purpose of and procedures required for the study, before the initiation of any study specific procedures
  • Aged 18 to 35 years
  • Diagnostic and Statistical Manual-IV (DSM-IV) diagnosed first episode psychosis, schizophrenia, schizoaffective disorder, psychosis not otherwise specified or schizophreniform disorder.
  • First episode (within first 5 years of diagnosis)
  • Competent and willing to give informed consent
  • Medication remained stable 4 weeks prior to baseline.
  • Able to take oral medication and likely to complete the required evaluations.
  • Female participants of child bearing capability must be willing to use adequate contraceptives for the duration of the study, and, willing to have a pregnancy test pre treatment and at ten weekly intervals while on study medication.

    1. Adequate contraception is defined as use of contraceptive double barrier system (i.e. condom and spermicide) or contraceptive implant, oral contraceptive or injected depot contraceptive plus other form of contraceptive i.e. condom. Females will be considered incapable of child bearing if they are one year post-menopausal or irreversibly surgically sterilised.

Exclusion Criteria:

  • Violation of any inclusion criteria
  • Failure to perform screening or baseline examinations
  • Relevant ICD 10 organic brain disease or neurological diagnoses
  • Patients with liver disease
  • Patients who will meet the criteria for a DSM-IV TR diagnosis of alcohol or substance abuse (other than for nicotine) within the last month or the criteria for DSM-IV TR alcohol or substance dependence (other than for nicotine) within the last 6 months
  • Any change of psychotropic medications within the previous 4 weeks
  • Recreational drugs or alcohol abuse
  • Pregnant or lactating women and those of reproductive age without adequate contraception
  • Relevant medical illness will be determined in the first instance by asking the patients mental health care team if the patient has any medical condition/problems. After consent has been obtained the research nurse/ research doctor will then have access to the patients' notes and will assess patient eligibility to take part in the clinical trial by scrutinising the patients' past medical history, most recent blood results, electrocardiograms, as well as any physical tests that have been performed on the patient.

Sites / Locations

  • Abasi Shaheed Hospital
  • Civil hospital Karachi
  • Institute of Behavioural Sciences
  • Karwn e Hayat

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Methotrexate

Arm Description

Matching placebo for methotrexate

Methotrexate 10 mg once a week orally

Outcomes

Primary Outcome Measures

Positive and Negative Syndrome Scale PANSS
PANSS is an assessment measures to assess severity of symptoms of schizophrenia

Secondary Outcome Measures

CogState
Measuring all seven domains recommended by MATRICS (NIMH initiative). These domains include speed processing, attention/vigilance, Working memory (nonverbal & verbal), verbal learning, visual learning, reasoning and problem solving and social cognitions.

Full Information

First Posted
February 26, 2014
Last Updated
September 19, 2015
Sponsor
Pakistan Institute of Living and Learning
Collaborators
Abbasi Shaheed Hospital, Dow University of Health Sciences, Karwan e Hayat, Karachi, Pakistan, Institute of Behavioural Sciences, Karachi, Pakistan
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1. Study Identification

Unique Protocol Identification Number
NCT02074319
Brief Title
RCT of Methotrexate Added to Treatment As Usual in Schizophrenia
Acronym
RECOVERY
Official Title
A Randomised Double Blind Placebo Controlled 12 Week Trial of Methotrexate Added to Treatment As Usual in Early Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
September 2015
Overall Recruitment Status
Completed
Study Start Date
December 2013 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
August 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pakistan Institute of Living and Learning
Collaborators
Abbasi Shaheed Hospital, Dow University of Health Sciences, Karwan e Hayat, Karachi, Pakistan, Institute of Behavioural Sciences, Karachi, Pakistan

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of the this study is to evaluate the effectiveness of methotrexate added to treatment as usual on positive and negative symptoms, cognitive and social functioning and quality of life of patients suffering from schizophrenia.
Detailed Description
The purpose of the study is to test the prediction that addition of methotrexate to treatment as usual (TAU) for patients with schizophrenia will result in following outcomes: Primary: improvement in negative symptoms improvement in positive symptoms Secondary: improvement in social functioning improvement in cognitive functions acceptability and tolerability of methotrexate added to TAU A total 72 participants (36 participants in intervention group and 36 in control group) meeting inclusion criteria of the study will be recruited and randomized in study in two arms. Research assistants and participating psychiatrists will assess participants for eligibility criteria. After providing detailed information regarding study by using patient information sheet, written informed consent will be taken from participants. Trained research assistant will asses participants at baseline, 2, 4, 6 and 12 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia, Schizoaffective Disorder, Schizophreniform Disorder
Keywords
Schizophrenia, Anti-Inflammatory, Methotrexate, Psychosis Not Otherwise Specified

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
92 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo for methotrexate
Arm Title
Methotrexate
Arm Type
Experimental
Arm Description
Methotrexate 10 mg once a week orally
Intervention Type
Drug
Intervention Name(s)
Methotrexate
Intervention Description
Treatment as usual or standard treatment for psychosis will be common in all arms
Primary Outcome Measure Information:
Title
Positive and Negative Syndrome Scale PANSS
Description
PANSS is an assessment measures to assess severity of symptoms of schizophrenia
Time Frame
3 months
Secondary Outcome Measure Information:
Title
CogState
Description
Measuring all seven domains recommended by MATRICS (NIMH initiative). These domains include speed processing, attention/vigilance, Working memory (nonverbal & verbal), verbal learning, visual learning, reasoning and problem solving and social cognitions.
Time Frame
3 months
Other Pre-specified Outcome Measures:
Title
Social Functioning Scale
Description
Self-rating questionnaire assessing social functioning in 7 domains.
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent, indicating that the subject understood the purpose of and procedures required for the study, before the initiation of any study specific procedures Aged 18 to 35 years Diagnostic and Statistical Manual-IV (DSM-IV) diagnosed first episode psychosis, schizophrenia, schizoaffective disorder, psychosis not otherwise specified or schizophreniform disorder. First episode (within first 5 years of diagnosis) Competent and willing to give informed consent Medication remained stable 4 weeks prior to baseline. Able to take oral medication and likely to complete the required evaluations. Female participants of child bearing capability must be willing to use adequate contraceptives for the duration of the study, and, willing to have a pregnancy test pre treatment and at ten weekly intervals while on study medication. Adequate contraception is defined as use of contraceptive double barrier system (i.e. condom and spermicide) or contraceptive implant, oral contraceptive or injected depot contraceptive plus other form of contraceptive i.e. condom. Females will be considered incapable of child bearing if they are one year post-menopausal or irreversibly surgically sterilised. Exclusion Criteria: Violation of any inclusion criteria Failure to perform screening or baseline examinations Relevant ICD 10 organic brain disease or neurological diagnoses Patients with liver disease Patients who will meet the criteria for a DSM-IV TR diagnosis of alcohol or substance abuse (other than for nicotine) within the last month or the criteria for DSM-IV TR alcohol or substance dependence (other than for nicotine) within the last 6 months Any change of psychotropic medications within the previous 4 weeks Recreational drugs or alcohol abuse Pregnant or lactating women and those of reproductive age without adequate contraception Relevant medical illness will be determined in the first instance by asking the patients mental health care team if the patient has any medical condition/problems. After consent has been obtained the research nurse/ research doctor will then have access to the patients' notes and will assess patient eligibility to take part in the clinical trial by scrutinising the patients' past medical history, most recent blood results, electrocardiograms, as well as any physical tests that have been performed on the patient.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Prof Imran B Chaudhry, MD
Organizational Affiliation
University of Manchester
Official's Role
Principal Investigator
Facility Information:
Facility Name
Abasi Shaheed Hospital
City
Karachi
State/Province
Sindh
ZIP/Postal Code
72000
Country
Pakistan
Facility Name
Civil hospital Karachi
City
Karachi
State/Province
Sindh
ZIP/Postal Code
72000
Country
Pakistan
Facility Name
Institute of Behavioural Sciences
City
Karachi
State/Province
Sindh
ZIP/Postal Code
72000
Country
Pakistan
Facility Name
Karwn e Hayat
City
Karachi
State/Province
Sindh
ZIP/Postal Code
72000
Country
Pakistan

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Links:
URL
http://pill.org.pk
Description
Website of Pakistan Institute of Learning and Living

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RCT of Methotrexate Added to Treatment As Usual in Schizophrenia

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