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Safety, Tolerability, and Pharmacokinetics of Switching From Oral Risperidone to Risperidone Implant (DLP-114)

Primary Purpose

Schizophrenia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Risperidone
Sponsored by
Delpor, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring risperidone, schizophrenia, implant

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Adult patients 18-70 years of age of both sexes diagnosed with schizophrenia or schizoaffective disorder according to DSM-V who have been stable on oral risperidone (2mg-3mg) for at least 2 weeks.
  2. Patient (and/or a patient's authorized legal representative) has provided written informed consent
  3. Patient meets the following criteria:

    1. Outpatient status
    2. PANSS Total Score ≤ 80 at screening.
    3. A score of ≤ 4 on the following PANSS items:

    i. Conceptual disorganization ii. Suspiciousness iii. Hallucinatory behavior iv. Unusual thought content v. Hostility d. CGI-I-S ≤ 4 (moderately ill)\Lack of clinically significant suicidal ideation or behavior; C-SSRS score type of 4-5 require evaluation by mental health professional to ensure patient safety in study

  4. Body Mass Index (BMI) within the range of 18.5 to 40.0 kg/m2 (inclusive);
  5. Ability to understand the nature and objectives of the trial, including risks and adverse events, and be able to read, review and sign the informed consent document prior to conduct of any study procedures;
  6. Willing and able to comply with the requirements of the study protocol; including willingness to visit the clinical facility for all outpatient visits and confinement periods;
  7. Have suitable venous access for blood sampling.
  8. Patient is assessed by the Investigator to be symptomatically stable with regard to pre-existing medical conditions as evidenced by medical history, non-clinically significant findings on physical examination, vital signs, clinical laboratory evaluations (hematology, serum chemistries, and urinalysis) or 12-lead electrocardiogram (ECG). Subjects may continue on their current prescribed medication regimens to control pre-existing medical and psychiatric conditions (other than schizophrenia) including the use of prescribed PRN medications.

Exclusion Criteria:

  1. PANSS score at baseline is ≥ 20% change from screening.
  2. Hospitalized or required acute crisis intervention for symptom exacerbation in the 60 days prior to admission as determined by the Investigator
  3. Patient has a history of suicide attempt in the last year, or in the opinion of the investigator is currently at imminent risk of suicide.
  4. Patient experiencing acute depressive symptoms within the past 30 days, according to the Investigator's opinion, that required treatment with an antidepressant
  5. Has a current or recent (within 12 months) DSM-V diagnosis of moderate or severe substance use disorder (except for tobacco use disorder) or has a positive urine drug screen for prohibited substances at screening.
  6. Have impaired hepatic (ALT/AST >1.5 times higher than the upper limit of normal) or renal function (eGFR<50 mL/min)
  7. Previously defined hypersensitivity to Risperidone
  8. History of neuroleptic malignant syndrome (NMS)
  9. Electroconvulsive therapy within 6 months of admission
  10. Requires current use of agents that are strong inhibitors and inducers of cytochrome P450;
  11. Known hypersensitivity or allergy to lidocaine or any local anesthetic agent of the amide type (local anesthetic used during implant and explant procedures);
  12. Presence of clinically significant skin disorders (such as, but not limited to, skin cancer, psoriasis, eczema, or atopic dermatitis), evidence of recent sunburn, scar tissue, tattoo, open sore, body piercing or branding at the intended implantation site that would interfere with the implantation procedure or interfere with implant site assessments as determined by the investigator;
  13. History of clinically significant hypersensitivity or allergic reactions;
  14. Known allergy or hypersensitivity to PABA;
  15. Known allergy or hypersensitivity to parabens, local anesthetics of the ester type, and sulfa drugs including antibiotics and thiazide diuretics;
  16. Known hypersensitivity to titanium, implant materials or procedure;
  17. Administration of an investigational drug or device within 1 month prior to first dosing;
  18. Positive result for hepatitis B surface antigen (HBsAg), hepatitis C (HCV) antibody, or HIV antibody;
  19. Pregnant or lactating patients. Positive pregnancy test;
  20. Positive drug test for Methamphetamines, Opiates, Cocaine, Phencyclidine, Benzodiazepines, Barbiturates, Methadone, Antidepressants and Amphetamines or positive alcohol test at screening or prior to first dose;
  21. Poor CYP2D6 metabolizer;
  22. History of skin picking or delusional parasitosis;
  23. Known history of abnormal scar formation or family history of keloid formation

Sites / Locations

  • Collaborative Neuroscience Research
  • Segal Trials

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

DLP-114 alpha-4 (6-months)

DLP-114 alpha-7 (12-months)

Arm Description

2 360mg Risperidone Implants

2 435mg Risperidone Implants

Outcomes

Primary Outcome Measures

Adverse Events
Determine the number and percent of patients experiencing a treatment-emergent adverse event;
Local Tolerance
Evaluate the incidence of local site reactions
Tolerability of Implantation and Explantation Procedures
Assess the incidence of local site reactions and/or Adverse Events (AEs) reported during the implantation and explantation procedures

Secondary Outcome Measures

Oral Pharmacokinetic (PK) Profile
Measure the plasma concentration of risperidone and 9-OH risperidone and active moiety (risperidone + 9 OH risperidone) following repeated oral administrations
Implant Pharmacokinetic (PK) Profile
Measure the plasma concentration of risperidone and 9-OH risperidone and active moiety (risperidone + 9 OH risperidone) following switch from oral risperidone to subcutaneous implantation of two DLP-114 devices.
Positive and Negative Syndrome Scale (PANSS)
Measure exploratory treatment outcomes using the 30-item Positive and Negative Syndrome Scale (PANSS). The PANSS provides a total score (sum of the scores of all 30 items) ranging from 30 to 210, higher scores indicate more severe neuropsychiatric symptoms of schizophrenia. Scores for 3 subscales, that is, for positive subscale (sum of the scores of all 7 items) and negative subscale (sum of the scores of all 7 items) ranges from 7 (absent) to 49 (extreme psychopathology), and for the general psychopathology subscale (sum of the scores of all 16 items) score ranges from 16 (absent) to 112 (extreme psychopathology)
Clinical Global Impression-Improvement (CGI-I) Scale
Measure exploratory treatment outcomes using the CGI-I scale. The CGI-I is a 7-point scale that requires the clinician to assess how much the participant's illness has improved or worsened relative to a baseline state at the beginning of the intervention and rated as: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse.
Mass Balance
Measure the amount of risperidone drug substance remaining in the DLP-114 reservoir following its removal, in order to estimate average daily output and duration
Implant device placement depth
Determine average depth of implant device placement measured by ultrasound in mm
Determine potential implant migration
Migration measured by the distance between the incision and the proximal end of the implant device

Full Information

First Posted
June 1, 2020
Last Updated
February 24, 2023
Sponsor
Delpor, Inc.
Collaborators
National Institute of Mental Health (NIMH)
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1. Study Identification

Unique Protocol Identification Number
NCT04418466
Brief Title
Safety, Tolerability, and Pharmacokinetics of Switching From Oral Risperidone to Risperidone Implant
Acronym
DLP-114
Official Title
Open-Label Study in Stable Schizophrenia Patients to Evaluate the Safety, Tolerability, and Pharmacokinetics of Switching From Oral Risperidone to Risperidone Implant (DLP-114)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
April 1, 2021 (Actual)
Primary Completion Date
February 10, 2023 (Actual)
Study Completion Date
February 10, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Delpor, Inc.
Collaborators
National Institute of Mental Health (NIMH)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes

5. Study Description

Brief Summary
This is an Open-Label Study in Stable Schizophrenia Patients to Evaluate the Safety, Tolerability, and Pharmacokinetics of Switching from Oral Risperidone to Risperidone Implant (DLP-114).
Detailed Description
Phase 1 open-label study in stable schizophrenia patients designed to evaluate the safety, tolerability, and PK of switching from 2 mg/day or 3 mg/day oral risperidone to two DLP-114 devices for a six or twelve-month dosing period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia
Keywords
risperidone, schizophrenia, implant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
DLP-114 alpha-4 (6-months)
Arm Type
Experimental
Arm Description
2 360mg Risperidone Implants
Arm Title
DLP-114 alpha-7 (12-months)
Arm Type
Experimental
Arm Description
2 435mg Risperidone Implants
Intervention Type
Combination Product
Intervention Name(s)
Risperidone
Other Intervention Name(s)
DLP-114
Intervention Description
Risperidone Implant
Primary Outcome Measure Information:
Title
Adverse Events
Description
Determine the number and percent of patients experiencing a treatment-emergent adverse event;
Time Frame
6-12 months
Title
Local Tolerance
Description
Evaluate the incidence of local site reactions
Time Frame
6-12 months
Title
Tolerability of Implantation and Explantation Procedures
Description
Assess the incidence of local site reactions and/or Adverse Events (AEs) reported during the implantation and explantation procedures
Time Frame
6-12 months
Secondary Outcome Measure Information:
Title
Oral Pharmacokinetic (PK) Profile
Description
Measure the plasma concentration of risperidone and 9-OH risperidone and active moiety (risperidone + 9 OH risperidone) following repeated oral administrations
Time Frame
24 hours
Title
Implant Pharmacokinetic (PK) Profile
Description
Measure the plasma concentration of risperidone and 9-OH risperidone and active moiety (risperidone + 9 OH risperidone) following switch from oral risperidone to subcutaneous implantation of two DLP-114 devices.
Time Frame
6-12 Months
Title
Positive and Negative Syndrome Scale (PANSS)
Description
Measure exploratory treatment outcomes using the 30-item Positive and Negative Syndrome Scale (PANSS). The PANSS provides a total score (sum of the scores of all 30 items) ranging from 30 to 210, higher scores indicate more severe neuropsychiatric symptoms of schizophrenia. Scores for 3 subscales, that is, for positive subscale (sum of the scores of all 7 items) and negative subscale (sum of the scores of all 7 items) ranges from 7 (absent) to 49 (extreme psychopathology), and for the general psychopathology subscale (sum of the scores of all 16 items) score ranges from 16 (absent) to 112 (extreme psychopathology)
Time Frame
6-12 Months
Title
Clinical Global Impression-Improvement (CGI-I) Scale
Description
Measure exploratory treatment outcomes using the CGI-I scale. The CGI-I is a 7-point scale that requires the clinician to assess how much the participant's illness has improved or worsened relative to a baseline state at the beginning of the intervention and rated as: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse.
Time Frame
6-12 Months
Title
Mass Balance
Description
Measure the amount of risperidone drug substance remaining in the DLP-114 reservoir following its removal, in order to estimate average daily output and duration
Time Frame
6-12 Months
Title
Implant device placement depth
Description
Determine average depth of implant device placement measured by ultrasound in mm
Time Frame
6-12 Months
Title
Determine potential implant migration
Description
Migration measured by the distance between the incision and the proximal end of the implant device
Time Frame
6-12 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult patients 18-70 years of age of both sexes diagnosed with schizophrenia or schizoaffective disorder according to DSM-V who have been stable on oral risperidone (2mg-3mg) for at least 2 weeks. Patient (and/or a patient's authorized legal representative) has provided written informed consent Patient meets the following criteria: Outpatient status PANSS Total Score ≤ 80 at screening. A score of ≤ 4 on the following PANSS items: i. Conceptual disorganization ii. Suspiciousness iii. Hallucinatory behavior iv. Unusual thought content v. Hostility d. CGI-I-S ≤ 4 (moderately ill)\Lack of clinically significant suicidal ideation or behavior; C-SSRS score type of 4-5 require evaluation by mental health professional to ensure patient safety in study Body Mass Index (BMI) within the range of 18.5 to 40.0 kg/m2 (inclusive); Ability to understand the nature and objectives of the trial, including risks and adverse events, and be able to read, review and sign the informed consent document prior to conduct of any study procedures; Willing and able to comply with the requirements of the study protocol; including willingness to visit the clinical facility for all outpatient visits and confinement periods; Have suitable venous access for blood sampling. Patient is assessed by the Investigator to be symptomatically stable with regard to pre-existing medical conditions as evidenced by medical history, non-clinically significant findings on physical examination, vital signs, clinical laboratory evaluations (hematology, serum chemistries, and urinalysis) or 12-lead electrocardiogram (ECG). Subjects may continue on their current prescribed medication regimens to control pre-existing medical and psychiatric conditions (other than schizophrenia) including the use of prescribed PRN medications. Exclusion Criteria: PANSS score at baseline is ≥ 20% change from screening. Hospitalized or required acute crisis intervention for symptom exacerbation in the 60 days prior to admission as determined by the Investigator Patient has a history of suicide attempt in the last year, or in the opinion of the investigator is currently at imminent risk of suicide. Patient experiencing acute depressive symptoms within the past 30 days, according to the Investigator's opinion, that required treatment with an antidepressant Has a current or recent (within 12 months) DSM-V diagnosis of moderate or severe substance use disorder (except for tobacco use disorder) or has a positive urine drug screen for prohibited substances at screening. Have impaired hepatic (ALT/AST >1.5 times higher than the upper limit of normal) or renal function (eGFR<50 mL/min) Previously defined hypersensitivity to Risperidone History of neuroleptic malignant syndrome (NMS) Electroconvulsive therapy within 6 months of admission Requires current use of agents that are strong inhibitors and inducers of cytochrome P450; Known hypersensitivity or allergy to lidocaine or any local anesthetic agent of the amide type (local anesthetic used during implant and explant procedures); Presence of clinically significant skin disorders (such as, but not limited to, skin cancer, psoriasis, eczema, or atopic dermatitis), evidence of recent sunburn, scar tissue, tattoo, open sore, body piercing or branding at the intended implantation site that would interfere with the implantation procedure or interfere with implant site assessments as determined by the investigator; History of clinically significant hypersensitivity or allergic reactions; Known allergy or hypersensitivity to PABA; Known allergy or hypersensitivity to parabens, local anesthetics of the ester type, and sulfa drugs including antibiotics and thiazide diuretics; Known hypersensitivity to titanium, implant materials or procedure; Administration of an investigational drug or device within 1 month prior to first dosing; Positive result for hepatitis B surface antigen (HBsAg), hepatitis C (HCV) antibody, or HIV antibody; Pregnant or lactating patients. Positive pregnancy test; Positive drug test for Methamphetamines, Opiates, Cocaine, Phencyclidine, Benzodiazepines, Barbiturates, Methadone, Antidepressants and Amphetamines or positive alcohol test at screening or prior to first dose; Poor CYP2D6 metabolizer; History of skin picking or delusional parasitosis; Known history of abnormal scar formation or family history of keloid formation
Facility Information:
Facility Name
Collaborative Neuroscience Research
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Segal Trials
City
Miami Lakes
State/Province
Florida
ZIP/Postal Code
33016
Country
United States

12. IPD Sharing Statement

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Safety, Tolerability, and Pharmacokinetics of Switching From Oral Risperidone to Risperidone Implant

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