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Safety and Tolerability Study of Single-dose Administration of Brexpiprazole in Adult Subjects With Schizophrenia

Primary Purpose

Schizophrenia

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Brexpiprazole, OPDC-34712
Sponsored by
Otsuka Pharmaceutical Development & Commercialization, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Schizophrenia

Eligibility Criteria

18 Years - 64 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males and females between 18 and 64 years of age, inclusive, at the screening visit with a diagnosis of schizophrenia as defined by DSM-V criteria.
  • Body mass index between 18 and 35 kg/m^2 at the screening visit.
  • Good physical health as determined by no clinically significant deviation from normal.
  • Ability to provide informed consent and/or consent obtained from a legally acceptable representative (as required by IRB), prior to the initiation of any protocol-required procedures.
  • Male and female subjects who are surgically sterile, female subjects who have been postmenopausal for at least 12 consecutive months prior to the screening visit, or male subjects/female subjects (of childbearing potential) who agree to remain abstinent or to practice 2 of the approved birth control methods from the screening visit and for at least 150 days after the dose of IMP for a female subject or 180 days after the dose of IMP for a male subject.

Exclusion Criteria:

  • Subjects who have:
  • Met DSM-V criteria for substance use disorder within the past 180 days; including alcohol and benzodiazepines, excluding caffeine/nicotine.
  • A positive drug screen for drugs of abuse (excluding stimulants, other prescribed medications, and marijuana [if in investigator's documented opinion the subject does not meet DSM-V criteria for substance use disorder]).
  • Use of more than 1 psychotropic medication at the screening or baseline visit, except for oral brexpiprazole administered during the brexpiprazole tolerability testing (if applicable) and current oral antipsychotic medication.
  • Use of varenicline beyond screening.
  • Subjects who have participated in any clinical trial involving a psychotropic medication within 1 month prior to the administration of IMP or 5 half-lives from last IMP administration whichever is longer.
  • Subjects who have a significant risk of committing suicide based on history, routine psychiatric status examination, investigator's judgment, or who have an answer of "yes" on questions 4 or 5 on the Baseline Version of the C-SSRS.
  • Subjects currently in an acute relapse of schizophrenia as assessed by the investigator.
  • Subjects with a current DSM-V diagnosis other than schizophrenia. Also, subjects with borderline, paranoid, histrionic, schizotypal, schizoid, or antisocial personality disorder.

Sites / Locations

  • Collaborative Neuro Science (CNS)
  • CNRI

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Part A: Single Dose Injection: Subcutaneous

Part A: Single Dose Injection: Intramuscular

Part B: Cohort 1

Part B: Cohort 2

Part B: Cohort 3

Arm Description

Drug: Brexpiprazole, OPDC-34712 Once, subcutaneous

Drug: Brexpiprazole, OPDC-34712 Once, subcutaneous

Drug: Brexpiprazole, OPDC-34712 Once, SC or IM

Drug: Brexpiprazole, OPDC-34712 Once, SC or IM

Drug: Brexpiprazole, OPDC-34712 Once, SC or IM

Outcomes

Primary Outcome Measures

Change in Suicidality via Columbia-Suicide Severity Rating Scale
Baseline version and Since Last Visit version of CSSRS will be completed by trained trial center staff
Number of reported Adverse Events (AE)
Clinical Laboratory Tests
Hematology, serum chemistry, urinalysis, drug screen, etc. will be performed.
Change in physical exam results
Investigator or designee will perform complete physical exam and document any clinically significant conditions. Body height and weight will also be measured for BMI calculation and weight will be measured as part of all subsequent physical exams.
Change in Systolic/Diastolic blood pressure from screening to end of study
Heart rate and body temperature will also be obtained prior to PK blood draws and ECG.
ECG Reading
12-lead ECG will be collected in triplicate (5 minutes apart). heart rate, ventricular rate, RR interval, PR interval, QRS duration and QT intervals will be recorded. QTcF and corrected QT interval using Bazett's formula will be calculated.
Extrapyramidal Symptoms (EPS) Rating Scale
SAS, AIMS & BARS will be assess by trained trial center staff
Investigator's assessment of injection site
Injection site will be assessed. Injection site will also be inspected for seepage after needle is withdrawn.
Visual analog scale (VAS) scores for pain reception

Secondary Outcome Measures

Maximum peak plasma concentration (Cmax) [Pharmacokinetics]
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411.
Time of Cmax (tmax) [Pharmacokinetics]
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Area under the concentration-time curve (AUC) from time zero to time "t" (Last observable concentration; AUCt) [Pharmacokinetics]
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
AUC from time zero to infinity (AUC∞) [Pharmacokinetics]
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Terminal-phase elimination half-life (t1/2,z) [Pharmacokinetics]
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Apparent clearance of drug from plasma after extravascular administration (CL/F; brexpiprazole only) [Pharmacokinetics]
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411

Full Information

First Posted
November 2, 2016
Last Updated
January 10, 2018
Sponsor
Otsuka Pharmaceutical Development & Commercialization, Inc.
Collaborators
H. Lundbeck A/S
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1. Study Identification

Unique Protocol Identification Number
NCT02968121
Brief Title
Safety and Tolerability Study of Single-dose Administration of Brexpiprazole in Adult Subjects With Schizophrenia
Official Title
A Phase 1, Two-part, Open-label, Randomized, Exploratory and Single Ascending Dose, Parallel Arm Trial to Determine the Pharmacokinetics, Safety, and Tolerability of Brexpiprazole Long-acting Injectable Administered Subcutaneously or Intramuscularly in Adult Subjects With Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Terminated
Why Stopped
Part A of study was completed per protocol. Conduct of Part B of the study (confirmatory phase) was not necessary.
Study Start Date
January 2017 (Actual)
Primary Completion Date
December 14, 2017 (Actual)
Study Completion Date
December 14, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Otsuka Pharmaceutical Development & Commercialization, Inc.
Collaborators
H. Lundbeck A/S

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To determine the pharmacokinetics, safety and tolerability of brexpiprazole administered subcutaneously or intramuscularly in adults with schizophrenia.
Detailed Description
This trial is designed to assess the pharmacokinetics, safety and tolerability of brexpiprazole in the treatment of subjects with schizophrenia. The trial will consist of two parts across 13-36 months. The trial population will include approximately 110 male & female subjects between 18 and 64 years of age (inclusive) with a diagnosis of schizophrenia as defined by DSM-V criteria.

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
Health Services Research
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part A: Single Dose Injection: Subcutaneous
Arm Type
Experimental
Arm Description
Drug: Brexpiprazole, OPDC-34712 Once, subcutaneous
Arm Title
Part A: Single Dose Injection: Intramuscular
Arm Type
Experimental
Arm Description
Drug: Brexpiprazole, OPDC-34712 Once, subcutaneous
Arm Title
Part B: Cohort 1
Arm Type
Experimental
Arm Description
Drug: Brexpiprazole, OPDC-34712 Once, SC or IM
Arm Title
Part B: Cohort 2
Arm Type
Experimental
Arm Description
Drug: Brexpiprazole, OPDC-34712 Once, SC or IM
Arm Title
Part B: Cohort 3
Arm Type
Experimental
Arm Description
Drug: Brexpiprazole, OPDC-34712 Once, SC or IM
Intervention Type
Drug
Intervention Name(s)
Brexpiprazole, OPDC-34712
Primary Outcome Measure Information:
Title
Change in Suicidality via Columbia-Suicide Severity Rating Scale
Description
Baseline version and Since Last Visit version of CSSRS will be completed by trained trial center staff
Time Frame
Part A: Screening to Day 182; Part B: Screening to Day 126
Title
Number of reported Adverse Events (AE)
Time Frame
Part A: 182 days; Part B: 126 days
Title
Clinical Laboratory Tests
Description
Hematology, serum chemistry, urinalysis, drug screen, etc. will be performed.
Time Frame
Part A: 182 days; Part B: 126 days
Title
Change in physical exam results
Description
Investigator or designee will perform complete physical exam and document any clinically significant conditions. Body height and weight will also be measured for BMI calculation and weight will be measured as part of all subsequent physical exams.
Time Frame
Part A: Screening to Day 182; Part B: Screening to Day 126
Title
Change in Systolic/Diastolic blood pressure from screening to end of study
Description
Heart rate and body temperature will also be obtained prior to PK blood draws and ECG.
Time Frame
Part A: Screening to Day 182; Part B: Screening to Day 126
Title
ECG Reading
Description
12-lead ECG will be collected in triplicate (5 minutes apart). heart rate, ventricular rate, RR interval, PR interval, QRS duration and QT intervals will be recorded. QTcF and corrected QT interval using Bazett's formula will be calculated.
Time Frame
Part A: 182 days; Part B: 126 days
Title
Extrapyramidal Symptoms (EPS) Rating Scale
Description
SAS, AIMS & BARS will be assess by trained trial center staff
Time Frame
Part A: 182 days; Part B: 126 days
Title
Investigator's assessment of injection site
Description
Injection site will be assessed. Injection site will also be inspected for seepage after needle is withdrawn.
Time Frame
Part A: 182 days; Part B: 126 days
Title
Visual analog scale (VAS) scores for pain reception
Time Frame
Part A: 182 days; Part B: 126 days
Secondary Outcome Measure Information:
Title
Maximum peak plasma concentration (Cmax) [Pharmacokinetics]
Description
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411.
Time Frame
Day 1 (predose [within 2 hours prior to dosing] and 4, 8 , and 12 hours postdose)
Title
Time of Cmax (tmax) [Pharmacokinetics]
Description
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Time Frame
Day 1 (predose [within 2 hours prior to dosing] and 4, 8 , and 12 hours postdose)
Title
Area under the concentration-time curve (AUC) from time zero to time "t" (Last observable concentration; AUCt) [Pharmacokinetics]
Description
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Time Frame
Day 1 (predose [within 2 hours prior to dosing] and 4, 8 , and 12 hours postdose)
Title
AUC from time zero to infinity (AUC∞) [Pharmacokinetics]
Description
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Time Frame
Day 1 (predose [within 2 hours prior to dosing] and 4, 8 , and 12 hours postdose)
Title
Terminal-phase elimination half-life (t1/2,z) [Pharmacokinetics]
Description
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Time Frame
Day 1 (predose [within 2 hours prior to dosing] and 4, 8 , and 12 hours postdose)
Title
Apparent clearance of drug from plasma after extravascular administration (CL/F; brexpiprazole only) [Pharmacokinetics]
Description
Samples will also be collected on Days 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 25, 28, 35, 42, 49, 56, 63, 70, 77, 84, 98, 112, 126, 154, and 182/ET or until plasma concentrations of brexpiprazole are BLQ, whichever is longer based on monthly PK sampling (samples will be collected between 8 AM and 2 PM on the indicated nondosing day). If a PK blood sample cannot be drawn at the designated time on Day 1, a window of ± 15 minutes for each blood draw is acceptable with the exact time recorded. PK parameters will be assessed for plasma brexpiprazole and its metabolite(s) including DM-3411
Time Frame
Day 1 (predose [within 2 hours prior to dosing] and 4, 8 , and 12 hours postdose)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
64 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females between 18 and 64 years of age, inclusive, at the screening visit with a diagnosis of schizophrenia as defined by DSM-V criteria. Body mass index between 18 and 35 kg/m^2 at the screening visit. Good physical health as determined by no clinically significant deviation from normal. Ability to provide informed consent and/or consent obtained from a legally acceptable representative (as required by IRB), prior to the initiation of any protocol-required procedures. Male and female subjects who are surgically sterile, female subjects who have been postmenopausal for at least 12 consecutive months prior to the screening visit, or male subjects/female subjects (of childbearing potential) who agree to remain abstinent or to practice 2 of the approved birth control methods from the screening visit and for at least 150 days after the dose of IMP for a female subject or 180 days after the dose of IMP for a male subject. Exclusion Criteria: Subjects who have: Met DSM-V criteria for substance use disorder within the past 180 days; including alcohol and benzodiazepines, excluding caffeine/nicotine. A positive drug screen for drugs of abuse (excluding stimulants, other prescribed medications, and marijuana [if in investigator's documented opinion the subject does not meet DSM-V criteria for substance use disorder]). Use of more than 1 psychotropic medication at the screening or baseline visit, except for oral brexpiprazole administered during the brexpiprazole tolerability testing (if applicable) and current oral antipsychotic medication. Use of varenicline beyond screening. Subjects who have participated in any clinical trial involving a psychotropic medication within 1 month prior to the administration of IMP or 5 half-lives from last IMP administration whichever is longer. Subjects who have a significant risk of committing suicide based on history, routine psychiatric status examination, investigator's judgment, or who have an answer of "yes" on questions 4 or 5 on the Baseline Version of the C-SSRS. Subjects currently in an acute relapse of schizophrenia as assessed by the investigator. Subjects with a current DSM-V diagnosis other than schizophrenia. Also, subjects with borderline, paranoid, histrionic, schizotypal, schizoid, or antisocial personality disorder.
Facility Information:
Facility Name
Collaborative Neuro Science (CNS)
City
Garden Grove
State/Province
California
ZIP/Postal Code
92845
Country
United States
Facility Name
CNRI
City
San Diego
State/Province
California
ZIP/Postal Code
92102
Country
United States

12. IPD Sharing Statement

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Safety and Tolerability Study of Single-dose Administration of Brexpiprazole in Adult Subjects With Schizophrenia

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