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Safety, Tolerability, and Pharmacokinetics of APN1125 in Subjects With Schizophrenia

Primary Purpose

Schizophrenia

Status
Suspended
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
APN1125
Placebo
Sponsored by
CoMentis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males and females of any race
  • 18 to 45 years of age, inclusive
  • Diagnosed with schizophrenia, as defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), in a non-acute (e.g., chronic) phase and clinically stable for at least 12 weeks before screening
  • Currently on a stable second-generation anti-psychotic regimen (stable dose and medication for 12 weeks)
  • Subjects (male and female) of childbearing potential must use two effective methods of contraception starting from the time of providing informed consent throughout the duration of the study and for 3 months after discharge
  • Women of childbearing potential must have a negative pregnancy test at screening and at admission

Exclusion Criteria:

  • Clinically significant abnormal serum electrolytes (sodium, potassium, calcium, and magnesium) after repeat testing
  • Insulin-dependent diabetes or insufficiently controlled diabetes mellitus in the judgment of the Investigator
  • Renal insufficiency with serum creatinine >1.6 mg/dL Malignant tumor within the 5 years before Screening with the exception of treated squamous and basal cell carcinoma, cervical carcinoma in situ, or brachytherapy for localized prostate cancer
  • Female subjects who are pregnant, breastfeeding, or planning to become pregnant during the study
  • Unstable medical condition that is clinically significant in the judgment of the Investigator
  • Body mass index (BMI) >38 kg/m^2 at Screening ALT or AST >1.5 times the upper limit of normal
  • Positive serology for hepatitis B surface antigen, hepatitis C antibody, or human immunodeficiency virus (HIV) 1 and/or 2 antibodies
  • Untreated clinically significant hypo- or hyperthyroidism; treated hypo- or hyperthyroidism should be stable for at least 8 weeks prior to Screening
  • History of myocardial infarction or unstable angina within 6 months before Screening
  • Cardiovascular disease history including symptomatic hypotension (supine systolic blood pressure [SBP] <90 mmHg or supine diastolic blood pressure [DBP] <60 mmHg), symptomatic orthostatic hypotension (orthostatic change in SBP >20 mmHg or DBP >15 mmHg), or hypertension (supine SBP >160 mmHg or supine DBP >95 mmHg ) or significant cardiac arrhythmia (in the judgment of the Investigator)
  • Clinically significant abnormality on Screening or Baseline electrocardiogram (ECG), including but not necessarily limited to a confirmed QTcF (QT interval corrected for heart rate using Fridericia's formula) interval value >450 msec for males or >470 msec for females
  • Current treatment with more than 2 atypical antipsychotics Psychiatric hospitalization due to breakthrough psychotic symptoms or acute exacerbations within 3 months before Day -1. Subjects with a recent "social" hospitalization may be screened after consultation with the Medical Monitor.
  • Subjects with other DSM-5 disorders are ineligible if the comorbid condition is clinically unstable or has been the primary focus of treatment within 3 months prior to Screening
  • Subjects meeting DSM-5 criteria for moderate to severe alcohol or substance use disorder (other than nicotine- or caffeine-related disorders) within 6 months prior to Screening
  • Urine drug screen (UDS) positive for drugs of abuse (excluding prescribed benzodiazepines) or positive alcohol breath test at Screening and/or Baseline (may be repeated once if, in the judgment of the Investigator, the subject does not meet DSM-5 criteria for moderate to severe substance abuse disorder)
  • Significant suicide risk as defined by 1) suicidal ideations as endorsed on items 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS) within the year prior to Screening or Baseline, 2) suicidal behaviors within the 2 years prior to Screening, or 3) Investigator assessment
  • History of stroke, brain tumor, subdural hematoma, Parkinson's Disease, dementia or other clinically significant neurological condition
  • Head trauma with loss of consciousness within 12 months prior to Screening
  • Active acute or chronic CNS infection
  • History of a seizure disorder
  • Immunosuppressants, including systemic corticosteroids (administered at an immunosuppressant dose in the judgment of the Investigator) (Note: Inhaled, nasal, or topical steroid use for allergy or other inflammation is permitted)
  • Any drugs with CNS activity (Note: Occasional (as needed) use of a sedative-hypnotic (e.g., benzodiazepine or nonbenzodiazepine [e.g., zolpidem, zaleplon, zopiclone, and eszopiclone]) as a sleep aid and stable second generation psychotics are permitted)
  • Prohibited antipsychotic medications (e.g., clozapine or typical, first-generation antipsychotics)
  • Excessive alcohol consumption (regular alcohol intake 14 units per week or more) or has a history of alcohol use disorder. Use of alcohol up to 48 hours before admission to the EPCU is not allowed.
  • Failure or inability to perform Screening or Baseline assessments
  • Exposure to an experimental drug or experimental medical device within 2 months before Screening, or an experimental biologic within 3 months before Screening

Sites / Locations

  • Collaborative Neuroscience Network

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

APN1125, Low Dose

APN1125, Mid Dose

APN1125, High Dose

Placebo

Arm Description

APN1125, Low Dose

APN1125, Mid Dose

APN1125, High Dose

Placebo to match

Outcomes

Primary Outcome Measures

Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via adverse events
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via vital signs (e.g., blood pressure, pulse rate, respiratory rate, oral temperature)
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via ECGs
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via physical exams
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via clinical laboratory tests (chemistry, hematology, coagulation and urinalysis)

Secondary Outcome Measures

Maximum observed plasma APN1125 concentration (Cmax)
Time corresponding to occurrence of Cmax (Tmax)
Area under the Curve from time zero to the last quantifiable plasma APN1125 concentration (AUClast)
Area under the Curve from time zero extrapolated to plasma APN1125 concentration at infinity (AUCinf)
Terminal plasma APN1125 rate constant (lambda z)
Apparent plasma APN1125 terminal half-life (t1/2)
Apparent APN1125 plasma clearance (CL/F)
Amount of unmetabolized APN1125 excreted in urine (Ae)
Fraction of unmetabolized APN1125 dose excreted in urine (Fe)

Full Information

First Posted
March 25, 2016
Last Updated
July 11, 2016
Sponsor
CoMentis
Collaborators
Alpharmagen, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02724917
Brief Title
Safety, Tolerability, and Pharmacokinetics of APN1125 in Subjects With Schizophrenia
Official Title
A Phase 1b/2a, Double-blind, Placebo-controlled, Multiple Ascending Dose Study to Evaluate the Safety, Tolerability and Pharmacokinetics of APN1125 in Subjects With Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
July 2016
Overall Recruitment Status
Suspended
Why Stopped
Study halted by sponsor for business reasons
Study Start Date
April 2016 (undefined)
Primary Completion Date
September 2016 (Anticipated)
Study Completion Date
December 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CoMentis
Collaborators
Alpharmagen, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study in patients with schizophrenia is to evaluate the safety, tolerability, and pharmacokinetics of 3 doses (low, mid, high) of APN1125 compared with placebo when administered as repeated daily oral doses.
Detailed Description
The purpose of this study is to evaluate the safety profile, tolerability and pharmacokinetics (PK) of APN1125 following 14 days of once-daily oral dosing in subjects with schizophrenia on stable second-generation antipsychotic therapy. This is a randomized, double-blind, 2-week, multiple ascending dose study of APN1125. This study will enroll up to three sequential cohorts of subjects diagnosed with schizophrenia, each randomly assigned to receive one of three doses (low, medium, or high) of APN1125 or matching placebo. Following admission to an Early Phase Clinical Unit (EPCU), APN1125 will be administered once daily for 2 weeks. All subjects will remain confined to the EPCU for a total of 20 days, consisting of admission, dosing and observation periods.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
APN1125, Low Dose
Arm Type
Experimental
Arm Description
APN1125, Low Dose
Arm Title
APN1125, Mid Dose
Arm Type
Experimental
Arm Description
APN1125, Mid Dose
Arm Title
APN1125, High Dose
Arm Type
Experimental
Arm Description
APN1125, High Dose
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo to match
Intervention Type
Drug
Intervention Name(s)
APN1125
Intervention Description
Oral solid dose form of APN1125
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Placebo to match
Intervention Description
Placebo to match
Primary Outcome Measure Information:
Title
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via adverse events
Time Frame
25 days
Title
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via vital signs (e.g., blood pressure, pulse rate, respiratory rate, oral temperature)
Time Frame
25 days
Title
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via ECGs
Time Frame
25 days
Title
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via physical exams
Time Frame
25 days
Title
Assessment of safety and tolerability of APN1125 in subjects with schizophrenia via clinical laboratory tests (chemistry, hematology, coagulation and urinalysis)
Time Frame
25 days
Secondary Outcome Measure Information:
Title
Maximum observed plasma APN1125 concentration (Cmax)
Time Frame
Days 1 and 14
Title
Time corresponding to occurrence of Cmax (Tmax)
Time Frame
Days 1 and 14
Title
Area under the Curve from time zero to the last quantifiable plasma APN1125 concentration (AUClast)
Time Frame
Days 1 and 14
Title
Area under the Curve from time zero extrapolated to plasma APN1125 concentration at infinity (AUCinf)
Time Frame
Days 1 and 14
Title
Terminal plasma APN1125 rate constant (lambda z)
Time Frame
Days 1 and 14
Title
Apparent plasma APN1125 terminal half-life (t1/2)
Time Frame
Days 1 and 14
Title
Apparent APN1125 plasma clearance (CL/F)
Time Frame
Days 1 and 14
Title
Amount of unmetabolized APN1125 excreted in urine (Ae)
Time Frame
Days 1 and 14
Title
Fraction of unmetabolized APN1125 dose excreted in urine (Fe)
Time Frame
Days 1 and 14

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females of any race 18 to 45 years of age, inclusive Diagnosed with schizophrenia, as defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), in a non-acute (e.g., chronic) phase and clinically stable for at least 12 weeks before screening Currently on a stable second-generation anti-psychotic regimen (stable dose and medication for 12 weeks) Subjects (male and female) of childbearing potential must use two effective methods of contraception starting from the time of providing informed consent throughout the duration of the study and for 3 months after discharge Women of childbearing potential must have a negative pregnancy test at screening and at admission Exclusion Criteria: Clinically significant abnormal serum electrolytes (sodium, potassium, calcium, and magnesium) after repeat testing Insulin-dependent diabetes or insufficiently controlled diabetes mellitus in the judgment of the Investigator Renal insufficiency with serum creatinine >1.6 mg/dL Malignant tumor within the 5 years before Screening with the exception of treated squamous and basal cell carcinoma, cervical carcinoma in situ, or brachytherapy for localized prostate cancer Female subjects who are pregnant, breastfeeding, or planning to become pregnant during the study Unstable medical condition that is clinically significant in the judgment of the Investigator Body mass index (BMI) >38 kg/m^2 at Screening ALT or AST >1.5 times the upper limit of normal Positive serology for hepatitis B surface antigen, hepatitis C antibody, or human immunodeficiency virus (HIV) 1 and/or 2 antibodies Untreated clinically significant hypo- or hyperthyroidism; treated hypo- or hyperthyroidism should be stable for at least 8 weeks prior to Screening History of myocardial infarction or unstable angina within 6 months before Screening Cardiovascular disease history including symptomatic hypotension (supine systolic blood pressure [SBP] <90 mmHg or supine diastolic blood pressure [DBP] <60 mmHg), symptomatic orthostatic hypotension (orthostatic change in SBP >20 mmHg or DBP >15 mmHg), or hypertension (supine SBP >160 mmHg or supine DBP >95 mmHg ) or significant cardiac arrhythmia (in the judgment of the Investigator) Clinically significant abnormality on Screening or Baseline electrocardiogram (ECG), including but not necessarily limited to a confirmed QTcF (QT interval corrected for heart rate using Fridericia's formula) interval value >450 msec for males or >470 msec for females Current treatment with more than 2 atypical antipsychotics Psychiatric hospitalization due to breakthrough psychotic symptoms or acute exacerbations within 3 months before Day -1. Subjects with a recent "social" hospitalization may be screened after consultation with the Medical Monitor. Subjects with other DSM-5 disorders are ineligible if the comorbid condition is clinically unstable or has been the primary focus of treatment within 3 months prior to Screening Subjects meeting DSM-5 criteria for moderate to severe alcohol or substance use disorder (other than nicotine- or caffeine-related disorders) within 6 months prior to Screening Urine drug screen (UDS) positive for drugs of abuse (excluding prescribed benzodiazepines) or positive alcohol breath test at Screening and/or Baseline (may be repeated once if, in the judgment of the Investigator, the subject does not meet DSM-5 criteria for moderate to severe substance abuse disorder) Significant suicide risk as defined by 1) suicidal ideations as endorsed on items 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS) within the year prior to Screening or Baseline, 2) suicidal behaviors within the 2 years prior to Screening, or 3) Investigator assessment History of stroke, brain tumor, subdural hematoma, Parkinson's Disease, dementia or other clinically significant neurological condition Head trauma with loss of consciousness within 12 months prior to Screening Active acute or chronic CNS infection History of a seizure disorder Immunosuppressants, including systemic corticosteroids (administered at an immunosuppressant dose in the judgment of the Investigator) (Note: Inhaled, nasal, or topical steroid use for allergy or other inflammation is permitted) Any drugs with CNS activity (Note: Occasional (as needed) use of a sedative-hypnotic (e.g., benzodiazepine or nonbenzodiazepine [e.g., zolpidem, zaleplon, zopiclone, and eszopiclone]) as a sleep aid and stable second generation psychotics are permitted) Prohibited antipsychotic medications (e.g., clozapine or typical, first-generation antipsychotics) Excessive alcohol consumption (regular alcohol intake 14 units per week or more) or has a history of alcohol use disorder. Use of alcohol up to 48 hours before admission to the EPCU is not allowed. Failure or inability to perform Screening or Baseline assessments Exposure to an experimental drug or experimental medical device within 2 months before Screening, or an experimental biologic within 3 months before Screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David P Walling, PhD
Organizational Affiliation
Collaborative Neuroscience Network
Official's Role
Principal Investigator
Facility Information:
Facility Name
Collaborative Neuroscience Network
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety, Tolerability, and Pharmacokinetics of APN1125 in Subjects With Schizophrenia

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