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Study to Determine the Safety, Tolerability, and Efficacy of Evenamide in Patients With Chronic Schizophrenia

Primary Purpose

Schizophrenia

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Evenamide
Placebo
Sponsored by
Newron Pharmaceuticals SPA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia

Eligibility Criteria

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

Inclusion Criteria:

Demographics

  • Age - 18 years, or older
  • Sex - male, or non-childbearing potential female unless practicing adequate contraception

Psychiatric

  • Has a current diagnosis of schizophrenia in accordance with DSM-5.
  • Has been treated with antipsychotics for at least 2 years.
  • Has a total score on the PANSS < 80.
  • Has a Clinical Global Impression - Severity of disease (CGI-S) rating of mildly, moderately or moderately severely ill (score of 3, 4 or 5).
  • Needs antipsychotic treatment and is currently receiving a stable dose (minimally for 4 weeks prior to screening) of aripiprazole, clozapine, quetiapine, olanzapine, paliperidone, or risperidone (at least 2 mg risperidone dose-equivalent)
  • Current symptoms have been stably present for at least one month

Procedural

  • Patient resides at home or in a residential care facility
  • If taking clozapine, patient agrees to blood monitoring

Exclusion Criteria:

Psychiatric

  • Severity of current episode of psychosis requires that the patient be hospitalized. Patients who are chronically hospitalized or in psychiatric day-care, whose hospitalization is for logistic reasons and not due to the severity of their illness, will be eligible for the study.
  • Severity of psychosis is rated severe or higher (CGI-S of 6 or greater).
  • Known suicidal risk. A "yes" response on the C-SSRS Suicidal Ideation Item 4 or Item 5, or a "yes" response on any of the five C-SSRS Suicidal Behavior items, at screening, or a suicide attempt within the past 6 months, excludes the patient from the study.
  • Patients with a diagnosis of Treatment resistance
  • History of neuroleptic malignant syndrome, priapism.
  • Current moderate or severe tardive dyskinesia.

Medical Status

  • Abnormal epileptiform phenomena (3 per second spike and slow wave discharges) observed on screening EEG. History or current diagnosis of epilepsy or seizure disorder (other than febrile seizures in childhood)
  • Insulin-dependent diabetes mellitus
  • History or current diagnosis of any neurodegenerative illnesses
  • Loss of 500 ml or more of blood during the 3-month period before study enrollment, e.g. as a donor

Cardiovascular

  • A current diagnosis of severe or unstable cardiovascular disease
  • Any clinically significant ECG abnormality
  • Abnormal vital signs

Laboratory abnormalities

  • Clinically significant abnormalities in routine laboratory examinations
  • History and/or presence of hepatitis B and/or C
  • Positive results from the HIV serology.
  • Positive results of the drug and alcohol tests
  • Clinically significant or unstable hypothyroidism or hyperthyroidism

Concomitant therapy

  • Treatment with SSRIs that are moderate/potent inhibitors of CYP2D6 (e.g. fluoxetine)
  • Treatment with drugs capable of inducing/inhibiting hepatic enzyme metabolism
  • Current treatment with sodium channel blockers
  • Exposure to any investigational drug within 5 weeks or 5 half-lives (whichever is longer) prior to screening
  • A known exaggerated pharmacological sensitivity or hypersensitivity to drugs similar to evenamide (e.g. lamotrigine, carbamazepine, oxcarbazepine, topiramate, etc.), or any components of the evenamide or matching placebo capsules
  • Treatment with a drug or treatment known to cause major organ system toxicity, e.g. tamoxifen, within 4 weeks, or received radiation therapy or a drug with cytotoxic potential, e.g. chemotherapy, during the past year
  • Electroconvulsive therapy (ECT) or treatment with a transcranial magnetic stimulation (TMS) device within 6 months prior to screening

Sites / Locations

  • Behavioral Research Specialists, LLC
  • CBH Health, LLC
  • Community Clinical Research CCR
  • Help Hospitals Clinical Research Department
  • St. John's Medical College Hospital
  • Mangala Hospital and Mangala Kidney Foundation, Department of Psychiatry
  • IQRAA Psychiatry Care and Rehabilitation Centre
  • Deenanath Mangeshkar Hospital Research Center
  • Sujata Birla Hospital
  • Post Graduate Institute of Medical Education and Research
  • Dayanand Medical College & Hospital
  • Sri Ramachandra Medical College, Department of Psychiatry
  • Ahana Hospital LLP
  • Asha Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Evenamide 7.5 mg bid

Evenamide 15 mg bid

Placebo

Arm Description

Evenamide capsules 7.5 mg BID for a total of 28 dosing days

Evenamide capsules 15.0 mg BID for a total of 28 dosing days

Matching placebo capsules BID for a total of 28 dosing days

Outcomes

Primary Outcome Measures

Safety and tolerability - incidence of Treatment-Emergent Adverse Events [TEAEs], Serious Adverse Events [AEs], and Adverse Events leading to discontinuation [ADOs]
Comparison will be made between the evenamide and placebo groups in the proportion of patients experiencing Serious Adverse Events [SAEs], Adverse Events leading to discontinuation [ADOs] and, Treatment-Emergent Adverse Events [TEAEs].
Change from baseline in Positive and Negative Syndrome Scale [PANSS] total score
Efficacy measure of mean change from baseline to endpoint of Positive and Negative Syndrome Scale [PANSS] total score: this is a 30-item scale that was designed to assess various symptoms of schizophrenia each rated on a 7-point scale that ranges from 1 (absent) to 7 (extreme psychopathology).

Secondary Outcome Measures

Key secondary - Change from baseline in clinical global impression severity of Illness [CGI-S] score
Efficacy measure by mean change from baseline top endpoint of the Clinical Global Impression Severity of Illness [CGI-S]: the investigator rates the severity of a subject's condition on a 7-point scale ranging from 1 (no symptoms) to 7 (very severe).
Rating at endpoint on the CGI - Change from baseline (CGI-C)
Efficacy measured by Clinical Global Impression of Change [CGI-C]: 7-point scale requiring the clinician to rate how much the patient's illness has improved at endpoint relative to the baseline state (score of 1, 2, 3); CGI-C ranges from 1 (very much improved) to 7 (very much worse), with a score of 4 indicating "no change".
Evaluate plasma drug concentrations over time for evenamide and its major metabolite, (3-butoxy-phenyl)-acetic acid
Determine the multiple-dose plasma concentrations of evenamide and its major metabolite, (3-butoxy-phenyl)-acetic acid, at the doses tested. Doses of evenamide to be evaluated in this study, compared to placebo, will be 7.5 mg bid, and 15 mg bid, with key information being collected at or near the time of the predicted maximal plasma concentration (Tmax) for evenamide.
Comparison of plasma drug concentrations over time for evenamide and its major metabolite, (3-butoxy-phenyl)-acetic acid between the dosing arms 7.5 mg BID and 15.0 mg BID
Determine if the PK parameters are dose proportional. Doses of evenamide to be evaluated in this study, compared to placebo, will be 7.5 mg bid, and 15 mg bid, with key information being collected at or near the time of the predicted maximal plasma concentration (Tmax) for evenamide.
Efficacy - changes in daily functioning
Determine the effect of evenamide, compared to placebo, on daily functioning, based on changes on the Strauss-Carpenter Level of Functioning (LOF) scale; The LOF is a semi-structured, clinician-administered scale of nine items. The individual items fall into four domains, with higher scores on a 5-point scale (0 - 4) reflecting better functioning. The subscales are Social Contacts (frequency and quality of social contacts), Work (quantity and quality of useful work), Symptomatology (absence of symptoms and recent hospitalization), and Function (ability to meet basic needs, fullness of life, and overall level of function). A total score is calculated as the sum of the raw scores across the nine items.
Efficacy - rating score of patient satisfaction with the study medication
Determine the patient's satisfaction with the study medication, compared to their previous treatment, based on improvements on the Medication Satisfaction Questionnaire (MSQ) which is a single-item, 7-point Likert-type scale for patients with schizophrenia to rate their satisfaction with their antipsychotic medication. The patient's response to the question "Overall, how satisfied are you with your current antipsychotic medication(s)?" is rated by the clinician as follows: 1 = extremely dissatisfied, 2 = very dissatisfied, 3 = somewhat dissatisfied, 4 = neither satisfied nor dissatisfied, 5 = somewhat satisfied, 6 = very satisfied, and 7 = extremely satisfied

Full Information

First Posted
June 19, 2020
Last Updated
May 17, 2021
Sponsor
Newron Pharmaceuticals SPA
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1. Study Identification

Unique Protocol Identification Number
NCT04461119
Brief Title
Study to Determine the Safety, Tolerability, and Efficacy of Evenamide in Patients With Chronic Schizophrenia
Official Title
A Phase II, Randomized, 4-Week, Double-Blind, Placebo-Controlled, Multiple-Dose Study, Designed to Determine the Safety, Tolerability, EEG Effects and Preliminary Efficacy of Fixed Oral Doses of 7.5 and 15 MG BID of Evenamide in Patients With Chronic Schizophrenia Who Are Symptomatic on Their Current Second-Generation Antipsychotic Medication
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
June 16, 2020 (Actual)
Primary Completion Date
February 20, 2021 (Actual)
Study Completion Date
March 13, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Newron Pharmaceuticals SPA

4. Oversight

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

5. Study Description

Brief Summary
This 4-week study will evaluate the safety, tolerability and preliminary evidence of efficacy of evenamide (7.5,and 15 mg and placebo, bid) treatment in outpatients with chronic schizophrenia.
Detailed Description
This is a prospective, 4-week, randomized, double-blind, placebo-controlled, study designed to evaluate the safety, tolerability, EEG effects, and preliminary efficacy of two fixed oral doses of evenamide of 7.5 mg and 15 mg bid (15 and 30 mg/day) in outpatients with chronic schizophrenia who are receiving treatment at constant doses of one of the following atypical antipsychotics: aripiprazole, clozapine, quetiapine, olanzapine, paliperidone or risperidone. Approximately 120 patients will be randomized in a 1:1:1 ratio to receive either evenamide 7.5 or 15 mg, or placebo, given bid.

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 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
138 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Evenamide 7.5 mg bid
Arm Type
Experimental
Arm Description
Evenamide capsules 7.5 mg BID for a total of 28 dosing days
Arm Title
Evenamide 15 mg bid
Arm Type
Experimental
Arm Description
Evenamide capsules 15.0 mg BID for a total of 28 dosing days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo capsules BID for a total of 28 dosing days
Intervention Type
Drug
Intervention Name(s)
Evenamide
Other Intervention Name(s)
NW-3509
Intervention Description
oral capsules for 4 weeks of treatment
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
oral capsules for 4 weeks of treatment
Primary Outcome Measure Information:
Title
Safety and tolerability - incidence of Treatment-Emergent Adverse Events [TEAEs], Serious Adverse Events [AEs], and Adverse Events leading to discontinuation [ADOs]
Description
Comparison will be made between the evenamide and placebo groups in the proportion of patients experiencing Serious Adverse Events [SAEs], Adverse Events leading to discontinuation [ADOs] and, Treatment-Emergent Adverse Events [TEAEs].
Time Frame
4 Week study
Title
Change from baseline in Positive and Negative Syndrome Scale [PANSS] total score
Description
Efficacy measure of mean change from baseline to endpoint of Positive and Negative Syndrome Scale [PANSS] total score: this is a 30-item scale that was designed to assess various symptoms of schizophrenia each rated on a 7-point scale that ranges from 1 (absent) to 7 (extreme psychopathology).
Time Frame
4 Week study
Secondary Outcome Measure Information:
Title
Key secondary - Change from baseline in clinical global impression severity of Illness [CGI-S] score
Description
Efficacy measure by mean change from baseline top endpoint of the Clinical Global Impression Severity of Illness [CGI-S]: the investigator rates the severity of a subject's condition on a 7-point scale ranging from 1 (no symptoms) to 7 (very severe).
Time Frame
4 Week study
Title
Rating at endpoint on the CGI - Change from baseline (CGI-C)
Description
Efficacy measured by Clinical Global Impression of Change [CGI-C]: 7-point scale requiring the clinician to rate how much the patient's illness has improved at endpoint relative to the baseline state (score of 1, 2, 3); CGI-C ranges from 1 (very much improved) to 7 (very much worse), with a score of 4 indicating "no change".
Time Frame
4 Week study
Title
Evaluate plasma drug concentrations over time for evenamide and its major metabolite, (3-butoxy-phenyl)-acetic acid
Description
Determine the multiple-dose plasma concentrations of evenamide and its major metabolite, (3-butoxy-phenyl)-acetic acid, at the doses tested. Doses of evenamide to be evaluated in this study, compared to placebo, will be 7.5 mg bid, and 15 mg bid, with key information being collected at or near the time of the predicted maximal plasma concentration (Tmax) for evenamide.
Time Frame
4 Week study
Title
Comparison of plasma drug concentrations over time for evenamide and its major metabolite, (3-butoxy-phenyl)-acetic acid between the dosing arms 7.5 mg BID and 15.0 mg BID
Description
Determine if the PK parameters are dose proportional. Doses of evenamide to be evaluated in this study, compared to placebo, will be 7.5 mg bid, and 15 mg bid, with key information being collected at or near the time of the predicted maximal plasma concentration (Tmax) for evenamide.
Time Frame
4 Week study
Title
Efficacy - changes in daily functioning
Description
Determine the effect of evenamide, compared to placebo, on daily functioning, based on changes on the Strauss-Carpenter Level of Functioning (LOF) scale; The LOF is a semi-structured, clinician-administered scale of nine items. The individual items fall into four domains, with higher scores on a 5-point scale (0 - 4) reflecting better functioning. The subscales are Social Contacts (frequency and quality of social contacts), Work (quantity and quality of useful work), Symptomatology (absence of symptoms and recent hospitalization), and Function (ability to meet basic needs, fullness of life, and overall level of function). A total score is calculated as the sum of the raw scores across the nine items.
Time Frame
4 Week study
Title
Efficacy - rating score of patient satisfaction with the study medication
Description
Determine the patient's satisfaction with the study medication, compared to their previous treatment, based on improvements on the Medication Satisfaction Questionnaire (MSQ) which is a single-item, 7-point Likert-type scale for patients with schizophrenia to rate their satisfaction with their antipsychotic medication. The patient's response to the question "Overall, how satisfied are you with your current antipsychotic medication(s)?" is rated by the clinician as follows: 1 = extremely dissatisfied, 2 = very dissatisfied, 3 = somewhat dissatisfied, 4 = neither satisfied nor dissatisfied, 5 = somewhat satisfied, 6 = very satisfied, and 7 = extremely satisfied
Time Frame
4 Week study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Demographics Age - 18 years, or older Sex - male, or non-childbearing potential female unless practicing adequate contraception Psychiatric Has a current diagnosis of schizophrenia in accordance with DSM-5. Has been treated with antipsychotics for at least 2 years. Has a total score on the PANSS < 80. Has a Clinical Global Impression - Severity of disease (CGI-S) rating of mildly, moderately or moderately severely ill (score of 3, 4 or 5). Needs antipsychotic treatment and is currently receiving a stable dose (minimally for 4 weeks prior to screening) of aripiprazole, clozapine, quetiapine, olanzapine, paliperidone, or risperidone (at least 2 mg risperidone dose-equivalent) Current symptoms have been stably present for at least one month Procedural Patient resides at home or in a residential care facility If taking clozapine, patient agrees to blood monitoring Exclusion Criteria: Psychiatric Severity of current episode of psychosis requires that the patient be hospitalized. Patients who are chronically hospitalized or in psychiatric day-care, whose hospitalization is for logistic reasons and not due to the severity of their illness, will be eligible for the study. Severity of psychosis is rated severe or higher (CGI-S of 6 or greater). Known suicidal risk. A "yes" response on the C-SSRS Suicidal Ideation Item 4 or Item 5, or a "yes" response on any of the five C-SSRS Suicidal Behavior items, at screening, or a suicide attempt within the past 6 months, excludes the patient from the study. Patients with a diagnosis of Treatment resistance History of neuroleptic malignant syndrome, priapism. Current moderate or severe tardive dyskinesia. Medical Status Abnormal epileptiform phenomena (3 per second spike and slow wave discharges) observed on screening EEG. History or current diagnosis of epilepsy or seizure disorder (other than febrile seizures in childhood) Insulin-dependent diabetes mellitus History or current diagnosis of any neurodegenerative illnesses Loss of 500 ml or more of blood during the 3-month period before study enrollment, e.g. as a donor Cardiovascular A current diagnosis of severe or unstable cardiovascular disease Any clinically significant ECG abnormality Abnormal vital signs Laboratory abnormalities Clinically significant abnormalities in routine laboratory examinations History and/or presence of hepatitis B and/or C Positive results from the HIV serology. Positive results of the drug and alcohol tests Clinically significant or unstable hypothyroidism or hyperthyroidism Concomitant therapy Treatment with SSRIs that are moderate/potent inhibitors of CYP2D6 (e.g. fluoxetine) Treatment with drugs capable of inducing/inhibiting hepatic enzyme metabolism Current treatment with sodium channel blockers Exposure to any investigational drug within 5 weeks or 5 half-lives (whichever is longer) prior to screening A known exaggerated pharmacological sensitivity or hypersensitivity to drugs similar to evenamide (e.g. lamotrigine, carbamazepine, oxcarbazepine, topiramate, etc.), or any components of the evenamide or matching placebo capsules Treatment with a drug or treatment known to cause major organ system toxicity, e.g. tamoxifen, within 4 weeks, or received radiation therapy or a drug with cytotoxic potential, e.g. chemotherapy, during the past year Electroconvulsive therapy (ECT) or treatment with a transcranial magnetic stimulation (TMS) device within 6 months prior to screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ravi Anand, MD
Organizational Affiliation
Newron Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Behavioral Research Specialists, LLC
City
Glendale
State/Province
California
ZIP/Postal Code
91206
Country
United States
Facility Name
CBH Health, LLC
City
Gaithersburg
State/Province
Maryland
ZIP/Postal Code
20877
Country
United States
Facility Name
Community Clinical Research CCR
City
Austin
State/Province
Texas
ZIP/Postal Code
78754
Country
United States
Facility Name
Help Hospitals Clinical Research Department
City
Vijayawada
State/Province
Andhra Pradesh
ZIP/Postal Code
520002
Country
India
Facility Name
St. John's Medical College Hospital
City
Koramangala
State/Province
Karnataka
Country
India
Facility Name
Mangala Hospital and Mangala Kidney Foundation, Department of Psychiatry
City
Mangalore
State/Province
Karnataka
Country
India
Facility Name
IQRAA Psychiatry Care and Rehabilitation Centre
City
Kozhikode
State/Province
Kerala
Country
India
Facility Name
Deenanath Mangeshkar Hospital Research Center
City
Pune
State/Province
Maharashtra
Country
India
Facility Name
Sujata Birla Hospital
City
Pune
State/Province
Maharashtra
Country
India
Facility Name
Post Graduate Institute of Medical Education and Research
City
Chandigarh
State/Province
Punjab
ZIP/Postal Code
160012
Country
India
Facility Name
Dayanand Medical College & Hospital
City
Ludhiana
State/Province
Punjab
Country
India
Facility Name
Sri Ramachandra Medical College, Department of Psychiatry
City
Chennai
State/Province
Tamil Nadu
ZIP/Postal Code
600116
Country
India
Facility Name
Ahana Hospital LLP
City
Madurai
State/Province
TamilNadu
Country
India
Facility Name
Asha Hospital
City
Hyderabad
State/Province
Telangana
ZIP/Postal Code
500034
Country
India

12. IPD Sharing Statement

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Study to Determine the Safety, Tolerability, and Efficacy of Evenamide in Patients With Chronic Schizophrenia

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