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MAintain the Efficacy and Safety in Treatment of Schizophrenia After Switching to Long-acTing Injectable aRipiprazole From Oral Atypical Antipsychotics (MAESTRO)

Primary Purpose

Schizophrenia, Antipsychotics, Long-Acting Injection

Status
Completed
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Abilify maintena
Sponsored by
Korea Otsuka Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring aripiprazole, Long-Acting Injection

Eligibility Criteria

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

Inclusion criteria

  1. Subjects who voluntarily consented to participating in the clinical trial.
  2. Male and female legally aged ≥19 and < 65 years.
  3. Subjects who were diagnosed of schizophrenia as defined by DSM diagnostic criteria, and were diagnosed of schizophrenia for at least for 2 years prior to screening.
  4. Subjects with all of the following schizophrenia clinical features:

    A. Outpatient subjects, with no hospitalization for worsening of schizophrenia within 3 months prior to screening.

    B. Subjects who have no more than a moderate rating on the PANSS total score≤80 C. 4 individual PANSS items, which are concerning to psychotic symptom (P2. conceptual disorganization, P3. hallucinatory behavior, P6. suspiciousness/persecution, G9. unusual thought content), score≤4.

    D. CGI-S score ≤4 (moderately ill).

  5. Subjects who take atypical antipsychotic drugs with the therapeutic effective dose (as specified in each label) for schizophrenia treatment, and should be maintained on the type and dose of the current antipsychotic drugs (including both typical and atypical antipsychotic drugs) for at least 4 weeks prior to the screening.
  6. Subjects who need antipsychotic treatment (other than clozapine), and would be stable when switching to Abilify Maintena on the investigator's judgement.
  7. Subjects must exhibit willingness, physiologic capability, and an educational level sufficient to comply with all protocol procedures as per the investigator's judgment.

Exclusion criteria

  1. Subject who showed medically significant adverse events or intolerance with aripiprazole during screening period or as prior experiences.
  2. Subjects with a current DSM diagnostic criteria-based diagnosis other than schizophrenia, including Schizoaffective disorder, major depressive disorder, bipolar disorder, delirium, neurocognitive disorder due to Alzheimer's or similar diseases, amnesia, borderline, paranoid, histrionic, schizotypal, schizoid, antisocial or other cognitive or personality disorders.
  3. Subjects with diseases of the central nervous system that may impact the assessment of the psychotic symptoms as per investigator's opinion.
  4. Subjects who have been treated with clozapine, electroconvulsive therapy (ECT) or other long-acting injectable antipsychotic drugs within 3 months prior to the screening.
  5. Subjects who have been treated more than 2 oral antipsychotic drugs (including both typical and atypical antipsychotic drugs) with the minimum therapeutic effective dose (as specified in each label) for schizophrenia treatment at screening.

    (e.g. Aripiprazole≥10 mg/day, Olanzapine≥10 mg/day, Risperidone≥2 mg/day, Quetiapine ≥150 mg/day)

  6. Subjects who have been treated with oral antipsychotic drugs (including both typical and atypical antipsychotic drugs) exceeding maximum maintenance dose (as specified in each label) at screening.

    (e.g. Aripiprazole>30 mg/day, Olanzapine>20 mg/day, Risperidone > 6 mg/day, Quetiapine > 750 mg/day)

  7. Subjects with a significant risk of violent behavior or a significant risk of committing suicide based on history or investigator's judgment.
  8. Subjects had a history of seizures, neuroleptic malignant syndrome, clinically significant tardive dyskinesia, or other medical condition that would expose them to undue risk or interfere with study assessments.
  9. Significant history of drug abuse disorder (excluding caffeine and nicotine, including alcohol, as defined in DSM-5 substance use disorder or in the opinion of the investigator) within the last 6 months prior to screening.
  10. Subjects who participated in another interventional clinical trial within 30 days prior to screening.
  11. Pregnant or lactating women, or women of childbearing potential who are not willing to or not able to use contraceptive methods (sexual abstinence; oral, implanted or injection hormone contraceptive methods; intrauterine device or condom; barrier contraceptive methods such as diaphragm and spermicide), accepted to avoid pregnancy until the end of the clinical trial.
  12. Subjects having any other clinically significant finding of the physical examination or laboratory value that make investigator consider that it would be inappropriate to participate in this study.

Sites / Locations

  • Konkuk University Chungju Hospital
  • Gongju National Hospital
  • Hanyang University Guri Hospital
  • Seoul National University Bundang Hospital
  • Cha Bundang Medical Center
  • The Catholic University of Korea Uijeongbu ST. Mary'S Hospital
  • Yong-In Mental Hospital
  • Jeju National University Hospital
  • Chonbuk National University Hospital
  • Keimyung University Dongsan Medical Center
  • Kyungpook National University Hospital
  • Yeungnam University Medical Center
  • Eulji University Hospital
  • Konyang University Hospital
  • Chungnam National University Hospital
  • Chonnam National University Hospital
  • Inha University Hospital
  • International St. Mary's Hospital
  • Inje University Haeundae Paik Hospital
  • Pusan National University Yangsan Hospital
  • Kangbuk Samsung Hospital
  • Samsung Medical Center
  • Eulji General Hospital
  • Ewha Womans University Mokdong Hospital
  • Korea University Anam Hospital
  • Kyung Hee University Hospital
  • Seoul National University Hosipital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Group 1

Group 2

Arm Description

Schizophrenia patients who are taking oral aripiprazole will be switched to Abilify maintena

Schizophrenia patients who are taking other oral atypical antipsychotics will be switched to Abilify maintena

Outcomes

Primary Outcome Measures

PANSS total score
Change in PANSS total score from baseline to Week 16

Secondary Outcome Measures

CGI-S
Change in CGI-S (severity) from baseline to Week 16
CGI-I
Mean CGI-I (improvement) score at Week 16
PANSS positive and negative subscale score
Change in PANSS positive and negative subscale score from baseline to Week 16
IAQ score
Mean IAQ score at Week 16

Full Information

First Posted
December 13, 2017
Last Updated
December 16, 2021
Sponsor
Korea Otsuka Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03376763
Brief Title
MAintain the Efficacy and Safety in Treatment of Schizophrenia After Switching to Long-acTing Injectable aRipiprazole From Oral Atypical Antipsychotics
Acronym
MAESTRO
Official Title
MAintain the Efficacy and Safety in Treatment of Schizophrenia After Switching to Long-acTing Injectable aRipiprazole From Oral Atypical Antipsychotics
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
November 21, 2017 (Actual)
Primary Completion Date
November 19, 2021 (Actual)
Study Completion Date
November 19, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Korea Otsuka Pharmaceutical Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Interventional, multicenter, open-label, 20 weeks study To identify efficacy and safety in switching from oral aripiprazole to Abilify Maintena. To identify efficacy and safety in switching from oral atypical antipsychotics other than aripiprazole to Abilify Maintena
Detailed Description
We would like to evaluate the efficacy and safety when switching to Abilify Maintena according to the approved indication of Abilify Maintena, for subjects who are taking oral antipsychotic drugs. It is expected that this will serve as a basis for suggesting a successful switching guideline from oral antipsychotics to Abilify Maintena, which can be applicable in clinical practice.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia, Antipsychotics, Long-Acting Injection, LAI, Aripiprazole
Keywords
aripiprazole, Long-Acting Injection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
201 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Experimental
Arm Description
Schizophrenia patients who are taking oral aripiprazole will be switched to Abilify maintena
Arm Title
Group 2
Arm Type
Experimental
Arm Description
Schizophrenia patients who are taking other oral atypical antipsychotics will be switched to Abilify maintena
Intervention Type
Drug
Intervention Name(s)
Abilify maintena
Other Intervention Name(s)
long-acting injectable aripiprazole
Intervention Description
Switching from oral atypical antipsychotics to long-acting injectable aripiprazole (Abilify maintena)
Primary Outcome Measure Information:
Title
PANSS total score
Description
Change in PANSS total score from baseline to Week 16
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
CGI-S
Description
Change in CGI-S (severity) from baseline to Week 16
Time Frame
16 weeks
Title
CGI-I
Description
Mean CGI-I (improvement) score at Week 16
Time Frame
16 weeks
Title
PANSS positive and negative subscale score
Description
Change in PANSS positive and negative subscale score from baseline to Week 16
Time Frame
16 weeks
Title
IAQ score
Description
Mean IAQ score at Week 16
Time Frame
16 weeks
Other Pre-specified Outcome Measures:
Title
study discontinuation rates
Description
Comparison the study discontinuation rates between Group 1 and Group 2
Time Frame
16 weeks
Title
study discontinuation rates
Description
Comparison the study discontinuation rates in Group 2 depending on the other oral atypical antipsychotics
Time Frame
16 weeks
Title
proportion of subjects who have more than 20% increased rating on the PANSS total score
Description
Comparison the proportion of subjects who have more than 20% increased rating on the PANSS total score from baseline to Week 16 between Group 1and Group 2
Time Frame
16 weeks
Title
proportion of subjects who have more than 20% increased rating on the PANSS total score
Description
Comparison the proportion of subjects who have more than 20% increased rating on the PANSS total score from baseline to Week 16 in Group 2 depending on the other oral atypical antipsychotics
Time Frame
16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
64 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria Subjects who voluntarily consented to participating in the clinical trial. Male and female legally aged ≥19 and < 65 years. Subjects who were diagnosed of schizophrenia as defined by DSM diagnostic criteria, and were diagnosed of schizophrenia for at least for 2 years prior to screening. Subjects with all of the following schizophrenia clinical features: A. Outpatient subjects, with no hospitalization for worsening of schizophrenia within 3 months prior to screening. B. Subjects who have no more than a moderate rating on the PANSS total score≤80 C. 4 individual PANSS items, which are concerning to psychotic symptom (P2. conceptual disorganization, P3. hallucinatory behavior, P6. suspiciousness/persecution, G9. unusual thought content), score≤4. D. CGI-S score ≤4 (moderately ill). Subjects who take atypical antipsychotic drugs with the therapeutic effective dose (as specified in each label) for schizophrenia treatment, and should be maintained on the type and dose of the current antipsychotic drugs (including both typical and atypical antipsychotic drugs) for at least 4 weeks prior to the screening. Subjects who need antipsychotic treatment (other than clozapine), and would be stable when switching to Abilify Maintena on the investigator's judgement. Subjects must exhibit willingness, physiologic capability, and an educational level sufficient to comply with all protocol procedures as per the investigator's judgment. Exclusion criteria Subject who showed medically significant adverse events or intolerance with aripiprazole during screening period or as prior experiences. Subjects with a current DSM diagnostic criteria-based diagnosis other than schizophrenia, including Schizoaffective disorder, major depressive disorder, bipolar disorder, delirium, neurocognitive disorder due to Alzheimer's or similar diseases, amnesia, borderline, paranoid, histrionic, schizotypal, schizoid, antisocial or other cognitive or personality disorders. Subjects with diseases of the central nervous system that may impact the assessment of the psychotic symptoms as per investigator's opinion. Subjects who have been treated with clozapine, electroconvulsive therapy (ECT) or other long-acting injectable antipsychotic drugs within 3 months prior to the screening. Subjects who have been treated more than 2 oral antipsychotic drugs (including both typical and atypical antipsychotic drugs) with the minimum therapeutic effective dose (as specified in each label) for schizophrenia treatment at screening. (e.g. Aripiprazole≥10 mg/day, Olanzapine≥10 mg/day, Risperidone≥2 mg/day, Quetiapine ≥150 mg/day) Subjects who have been treated with oral antipsychotic drugs (including both typical and atypical antipsychotic drugs) exceeding maximum maintenance dose (as specified in each label) at screening. (e.g. Aripiprazole>30 mg/day, Olanzapine>20 mg/day, Risperidone > 6 mg/day, Quetiapine > 750 mg/day) Subjects with a significant risk of violent behavior or a significant risk of committing suicide based on history or investigator's judgment. Subjects had a history of seizures, neuroleptic malignant syndrome, clinically significant tardive dyskinesia, or other medical condition that would expose them to undue risk or interfere with study assessments. Significant history of drug abuse disorder (excluding caffeine and nicotine, including alcohol, as defined in DSM-5 substance use disorder or in the opinion of the investigator) within the last 6 months prior to screening. Subjects who participated in another interventional clinical trial within 30 days prior to screening. Pregnant or lactating women, or women of childbearing potential who are not willing to or not able to use contraceptive methods (sexual abstinence; oral, implanted or injection hormone contraceptive methods; intrauterine device or condom; barrier contraceptive methods such as diaphragm and spermicide), accepted to avoid pregnancy until the end of the clinical trial. Subjects having any other clinically significant finding of the physical examination or laboratory value that make investigator consider that it would be inappropriate to participate in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jun Soo Kwon, Dr.
Organizational Affiliation
Seoul National University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Konkuk University Chungju Hospital
City
Chungju
State/Province
Chungcheongbuk-do
ZIP/Postal Code
27376
Country
Korea, Republic of
Facility Name
Gongju National Hospital
City
Gongju
State/Province
Chungcheongnam-do
ZIP/Postal Code
32601
Country
Korea, Republic of
Facility Name
Hanyang University Guri Hospital
City
Guri-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
Facility Name
Seoul National University Bundang Hospital
City
Seongnam-si,
State/Province
Gyeonggi-do
Country
Korea, Republic of
Facility Name
Cha Bundang Medical Center
City
Seongnam-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
Facility Name
The Catholic University of Korea Uijeongbu ST. Mary'S Hospital
City
Uijeongbu Si
State/Province
Gyeonggi-do
Country
Korea, Republic of
Facility Name
Yong-In Mental Hospital
City
Yongin-si
State/Province
Gyeonggi-do
ZIP/Postal Code
17089
Country
Korea, Republic of
Facility Name
Jeju National University Hospital
City
Jeju
State/Province
Jeju-do
ZIP/Postal Code
63241
Country
Korea, Republic of
Facility Name
Chonbuk National University Hospital
City
Jeonju
State/Province
Jeollabuk-do
Country
Korea, Republic of
Facility Name
Keimyung University Dongsan Medical Center
City
Daegu
Country
Korea, Republic of
Facility Name
Kyungpook National University Hospital
City
Daegu
Country
Korea, Republic of
Facility Name
Yeungnam University Medical Center
City
Daegu
Country
Korea, Republic of
Facility Name
Eulji University Hospital
City
Daejeon
ZIP/Postal Code
35233
Country
Korea, Republic of
Facility Name
Konyang University Hospital
City
Daejeon
ZIP/Postal Code
35365
Country
Korea, Republic of
Facility Name
Chungnam National University Hospital
City
Daejeon
Country
Korea, Republic of
Facility Name
Chonnam National University Hospital
City
Gwangju
Country
Korea, Republic of
Facility Name
Inha University Hospital
City
Incheon
ZIP/Postal Code
22332
Country
Korea, Republic of
Facility Name
International St. Mary's Hospital
City
Incheon
Country
Korea, Republic of
Facility Name
Inje University Haeundae Paik Hospital
City
Pusan
Country
Korea, Republic of
Facility Name
Pusan National University Yangsan Hospital
City
Pusan
Country
Korea, Republic of
Facility Name
Kangbuk Samsung Hospital
City
Seoul
ZIP/Postal Code
03181
Country
Korea, Republic of
Facility Name
Samsung Medical Center
City
Seoul
ZIP/Postal Code
06351
Country
Korea, Republic of
Facility Name
Eulji General Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Ewha Womans University Mokdong Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Korea University Anam Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Kyung Hee University Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul National University Hosipital
City
Seoul
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
Citation
Aripiprazole Investigator Brochure, Version No. 20, 16 Aug 2016
Results Reference
background
PubMed Identifier
8427558
Citation
Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993 Feb;50(2):85-94. doi: 10.1001/archpsyc.1993.01820140007001.
Results Reference
result
Citation
Hong Kyu Ihm et al. Factors Related to Medication Adherence in Outpatients with Schizophrenia under More Than 5 Years of Treatment. J Korean Neuropsychiatr Assoc 2016; 55(4):397-406
Results Reference
result
Citation
Hyun-Ku Kang, et al. Safety and Effectiveness of Long Acting Injectable Antipsychotic Paliperidone Palmitate Treatment in Schizophrenics: A 24-Week Open-Label Study. Korean J Biol Psychiatry 2013;20:111-117
Results Reference
result
PubMed Identifier
7872841
Citation
Gilbert PL, Harris MJ, McAdams LA, Jeste DV. Neuroleptic withdrawal in schizophrenic patients. A review of the literature. Arch Gen Psychiatry. 1995 Mar;52(3):173-88. doi: 10.1001/archpsyc.1995.03950150005001. No abstract available.
Results Reference
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PubMed Identifier
11691689
Citation
Gitlin M, Nuechterlein K, Subotnik KL, Ventura J, Mintz J, Fogelson DL, Bartzokis G, Aravagiri M. Clinical outcome following neuroleptic discontinuation in patients with remitted recent-onset schizophrenia. Am J Psychiatry. 2001 Nov;158(11):1835-42. doi: 10.1176/appi.ajp.158.11.1835.
Results Reference
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PubMed Identifier
22697189
Citation
Kane JM, Sanchez R, Perry PP, Jin N, Johnson BR, Forbes RA, McQuade RD, Carson WH, Fleischhacker WW. Aripiprazole intramuscular depot as maintenance treatment in patients with schizophrenia: a 52-week, multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2012 May;73(5):617-24. doi: 10.4088/JCP.11m07530.
Results Reference
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PubMed Identifier
26232241
Citation
Naber D, Hansen K, Forray C, Baker RA, Sapin C, Beillat M, Peters-Strickland T, Nylander AG, Hertel P, Andersen HS, Eramo A, Loze JY, Potkin SG. Qualify: a randomized head-to-head study of aripiprazole once-monthly and paliperidone palmitate in the treatment of schizophrenia. Schizophr Res. 2015 Oct;168(1-2):498-504. doi: 10.1016/j.schres.2015.07.007. Epub 2015 Jul 29.
Results Reference
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Citation
Seockhoon Chung, Chang Yoon Kim. et al. Effectiveness and Tolerability of Long-Acting Risperidone:A 12 Weeks, Multi-center Switching Study from Oral Antipsychotics. Korean J Psychopharmacol 16/2:109-120, 2005
Results Reference
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PubMed Identifier
24925984
Citation
Fleischhacker WW, Sanchez R, Perry PP, Jin N, Peters-Strickland T, Johnson BR, Baker RA, Eramo A, McQuade RD, Carson WH, Walling D, Kane JM. Aripiprazole once-monthly for treatment of schizophrenia: double-blind, randomised, non-inferiority study. Br J Psychiatry. 2014 Aug;205(2):135-44. doi: 10.1192/bjp.bp.113.134213. Epub 2014 Jun 12.
Results Reference
result
Links:
URL
http://mfds.go.kr/index.do?mid=1769&seq=12790
Description
Clinical trial guideline for Antipsychotics; Ministry Food And Drug, 2015.09.
URL
http://www.korea.kr/archive/expDocView.do?docId=37547
Description
The survey of Mental Disorders in Korea; Ministry of Health and Welfare, 2016
URL
https://ezdrug.mfds.go.kr/#!CCBAA03F020
Description
Abilify Maintena Package Insert in Korea
URL
https://ezdrug.mfds.go.kr/#!CCBAA03F020
Description
Abilify Package Insert in Korea

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MAintain the Efficacy and Safety in Treatment of Schizophrenia After Switching to Long-acTing Injectable aRipiprazole From Oral Atypical Antipsychotics

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