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Comparison of the Effectiveness of Brexpiprazole With That of Risperidone (TAILWIND)

Primary Purpose

Schizophrenia

Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
brexpiprazole
risperidone
Sponsored by
H. Lundbeck A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The patient has schizophrenia diagnosed according to DSM-5™
  • The patient has his or her first formal diagnosis of schizophrenia less than 10 years ago
  • The patient has been prescribed outpatient oral antipsychotic treatment at recommended dose range as stated in the Summary of product characteristics or equivalent document/label for the full 3 months prior to the Screening Visit.
  • The patient has CGI-S score of 3 (mildly ill) or 4 (moderately ill) at the Screening and Baseline Visits.
  • The patient has a Global Assessment Scale (GAS) score of 41 to 70 (limits included) at the Screening and Baseline Visits.
  • The patient is in need of a change in the current antipsychotic treatment due to insufficient functional improvement and, in the judgement of the investigator, would benefit from a switch to another treatment. Reasons for switching include but are not limited to the following reasons:

    1. lack of adequate response to his or her current antipsychotic medication,
    2. poor tolerability to his or her current antipsychotic medication,
    3. unwillingness of the patient to adhere to his or her current antipsychotic medication.

Exclusion Criteria:

  • The patient has a psychiatric disorder (DSM-5™ criteria) other than schizophrenia established as the primary diagnosis.
  • The patient is experiencing acute exacerbation of psychotic symptoms at the Screening Visit, between the Screening and Baseline Visits or at the Baseline Visit.
  • The patient is hospitalised for his or her psychotic symptoms at the Screening Visit, between the Screening and Baseline Visits or at the Baseline Visit.
  • The patient is treated with brexpiprazole, risperidone or clozapine at the time of Screening Visit.
  • The patient has shown, in the investigator's judgment, significant lack of efficacy to brexpiprazole, risperidone or paliperidone when treated at recommended dose range as stated in their respective Summary of product characteristics or equivalent document/ label, in a manner that would preclude benefiting from the study medication if randomised to brexpiprazole or risperidone during the study.
  • The patient is considered resistant to antipsychotic treatment according to the investigator's judgement.
  • The patient is at significant risk of harming himself/herself, or others according to the investigator's judgement or based on the Columbia Suicide Severity Rating Scale (C-SSRS).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    brexpiprazole

    risperidone

    Arm Description

    Outcomes

    Primary Outcome Measures

    Change in Quality of life (QLS total score)
    Evaluated by non-inferiority followed by superiority if non-inferiority is confirmed. The Quality of Life Scale (QLS) is a clinician-rated scale designed to assess deficit symptoms of schizophrenia and functioning during the preceding 4 weeks. The QLS consists of 21 items in 4 domains: Interpersonal Relations (eight items), Instrumental Role (four items), Intrapsychic Foundations (seven items), and Common Objects and Activities (two items). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning). Definitions are provided for 4 anchor points of the 7 points. Each item has a brief description of the judgement to be made and a set of suggested probes for the clinician. The total score is calculated as the sum of all 21 items giving a range of 0 to 126, where the higher score indicates normal or unimpaired functioning

    Secondary Outcome Measures

    Change in the 'Interpersonal Relations' QLS Domain Score
    The Interpersonal Relations domain score is the sum of 8 items (numbers 1 to 8). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning), giving a range of 0 to 48, where the higher score indicates normal or unimpaired functioning
    Change in the 'Instrumental Role' QLS Domain Score
    The Instrumental Role domain score is calculated as the sum of 4 items (numbers 9 to 12). Each item is rated on a 7-point scale, from 0 (severe where the higher score indicates normal or unimpaired functioning
    Change in the 'Intrapsychic Foundations' QLS Domain Score
    The Intrapsychic Foundations domain score is calculated as the sum of 7 items (numbers 13 to 17 and 20 and 21). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning), giving a range of 0 to 42, where the higher score indicates normal or unimpaired functioning
    Change in the 'Common Objects and Activities' QLS Domain Score
    The Common Objects and Activities score is calculated as the sum of 2 items (numbers 18 and 19). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning), giving a range of 0 to 12, where the higher score indicates normal or unimpaired functioning
    Change in Global severity of illness (CGI-S)
    Clinical Global Impression - Severity of Illness (CGI-S) score provides the clinician's impression of the patient's current state of mental illness. The clinician uses his or her clinical experience of this patient population to rate the severity of the patient's current mental illness on a 7-point scale ranging from 1 (normal - not at all ill) to 7 (among the most extremely ill patients).
    Investigator's Assessment Questionnaire (IAQ) Total Score
    The IAQ is a clinician-rated scale designed to assess the relative effectiveness (efficacy, safety and tolerability) of antipsychotic medications in patients with schizophrenia or schizoaffective disorder. The IAQ consists of 12 items: positive symptoms, negative symptoms, other efficacy symptoms, cognition, energy, mood, somnolence, weight gain, signs and symptoms of prolactin elevation, akathisia, extrapyramidal symptoms (EPS) (other than akathisia) and other safety or tolerability issues. For each item, the current medication is compared with previous antipsychotic medication on a five-point scale from 1 (Much better) to 5 (Much worse), or that item is Not applicable
    Functional response (QLS total score)
    Defined as change from Baseline in QLS total score of ≥10 points
    Readiness for Work Questionnaire (WoRQ)
    The Readiness for Work Questionnaire (WoRQ) is a clinician-rated scale designed to measure a schizophrenic patient's ability to work. The WoRQ total score is based on 7 statements. The statements is rated on a four-point scale, from 'strongly agree', 'agree', 'disagree' or 'strongly disagree'. Lower WoRQ total scores indicate better functioning
    Work readiness status (from the WoRQ)
    The work readiness status is assessed by the clinician. The 7 statements from WoRQ are used to aid in reaching the dichotomous work readiness judgment where the clinician must indicate (yes or no) if the patient is ready for work or not
    Time to discontinuation

    Full Information

    First Posted
    April 29, 2016
    Last Updated
    July 29, 2016
    Sponsor
    H. Lundbeck A/S
    Collaborators
    Otsuka Pharmaceutical Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02758067
    Brief Title
    Comparison of the Effectiveness of Brexpiprazole With That of Risperidone
    Acronym
    TAILWIND
    Official Title
    Interventional, Randomised, Double-blind, Parallel-group, Active-comparator, Flexible-dose Study to Compare the Effectiveness of Brexpiprazole to That of Risperidone in Adult Patients With Schizophrenia
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2016
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    This study was withdrawn for administrative reasons. There were no safety concerns.
    Study Start Date
    June 2016 (undefined)
    Primary Completion Date
    June 2016 (Actual)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    H. Lundbeck A/S
    Collaborators
    Otsuka Pharmaceutical Co., Ltd.

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    To demonstrate that the effectiveness of brexpiprazole (2-4 mg/day) on quality of life is non-inferior to that of risperidone (4-6 mg/day) in adult patients with schizophrenia.

    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 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    brexpiprazole
    Arm Type
    Experimental
    Arm Title
    risperidone
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    brexpiprazole
    Other Intervention Name(s)
    Rexulti (R)
    Intervention Description
    2- 4 mg/day, tablets, oral, 28-weeks
    Intervention Type
    Drug
    Intervention Name(s)
    risperidone
    Intervention Description
    4-6 mg/day, tablets, oral, 28-weeks
    Primary Outcome Measure Information:
    Title
    Change in Quality of life (QLS total score)
    Description
    Evaluated by non-inferiority followed by superiority if non-inferiority is confirmed. The Quality of Life Scale (QLS) is a clinician-rated scale designed to assess deficit symptoms of schizophrenia and functioning during the preceding 4 weeks. The QLS consists of 21 items in 4 domains: Interpersonal Relations (eight items), Instrumental Role (four items), Intrapsychic Foundations (seven items), and Common Objects and Activities (two items). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning). Definitions are provided for 4 anchor points of the 7 points. Each item has a brief description of the judgement to be made and a set of suggested probes for the clinician. The total score is calculated as the sum of all 21 items giving a range of 0 to 126, where the higher score indicates normal or unimpaired functioning
    Time Frame
    Baseline to Week 28
    Secondary Outcome Measure Information:
    Title
    Change in the 'Interpersonal Relations' QLS Domain Score
    Description
    The Interpersonal Relations domain score is the sum of 8 items (numbers 1 to 8). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning), giving a range of 0 to 48, where the higher score indicates normal or unimpaired functioning
    Time Frame
    Baseline to Week 28
    Title
    Change in the 'Instrumental Role' QLS Domain Score
    Description
    The Instrumental Role domain score is calculated as the sum of 4 items (numbers 9 to 12). Each item is rated on a 7-point scale, from 0 (severe where the higher score indicates normal or unimpaired functioning
    Time Frame
    Baseline to Week 28
    Title
    Change in the 'Intrapsychic Foundations' QLS Domain Score
    Description
    The Intrapsychic Foundations domain score is calculated as the sum of 7 items (numbers 13 to 17 and 20 and 21). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning), giving a range of 0 to 42, where the higher score indicates normal or unimpaired functioning
    Time Frame
    Baseline to Week 28
    Title
    Change in the 'Common Objects and Activities' QLS Domain Score
    Description
    The Common Objects and Activities score is calculated as the sum of 2 items (numbers 18 and 19). Each item is rated on a 7-point scale, from 0 (severe impairment) to 6 (normal or unimpaired functioning), giving a range of 0 to 12, where the higher score indicates normal or unimpaired functioning
    Time Frame
    Baseline to Week 28
    Title
    Change in Global severity of illness (CGI-S)
    Description
    Clinical Global Impression - Severity of Illness (CGI-S) score provides the clinician's impression of the patient's current state of mental illness. The clinician uses his or her clinical experience of this patient population to rate the severity of the patient's current mental illness on a 7-point scale ranging from 1 (normal - not at all ill) to 7 (among the most extremely ill patients).
    Time Frame
    Baseline to Week 28
    Title
    Investigator's Assessment Questionnaire (IAQ) Total Score
    Description
    The IAQ is a clinician-rated scale designed to assess the relative effectiveness (efficacy, safety and tolerability) of antipsychotic medications in patients with schizophrenia or schizoaffective disorder. The IAQ consists of 12 items: positive symptoms, negative symptoms, other efficacy symptoms, cognition, energy, mood, somnolence, weight gain, signs and symptoms of prolactin elevation, akathisia, extrapyramidal symptoms (EPS) (other than akathisia) and other safety or tolerability issues. For each item, the current medication is compared with previous antipsychotic medication on a five-point scale from 1 (Much better) to 5 (Much worse), or that item is Not applicable
    Time Frame
    Baseline to Week 28
    Title
    Functional response (QLS total score)
    Description
    Defined as change from Baseline in QLS total score of ≥10 points
    Time Frame
    at Week 28
    Title
    Readiness for Work Questionnaire (WoRQ)
    Description
    The Readiness for Work Questionnaire (WoRQ) is a clinician-rated scale designed to measure a schizophrenic patient's ability to work. The WoRQ total score is based on 7 statements. The statements is rated on a four-point scale, from 'strongly agree', 'agree', 'disagree' or 'strongly disagree'. Lower WoRQ total scores indicate better functioning
    Time Frame
    Baseline to Week 28
    Title
    Work readiness status (from the WoRQ)
    Description
    The work readiness status is assessed by the clinician. The 7 statements from WoRQ are used to aid in reaching the dichotomous work readiness judgment where the clinician must indicate (yes or no) if the patient is ready for work or not
    Time Frame
    at Week 28
    Title
    Time to discontinuation
    Time Frame
    from Baseline to Week 28

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: The patient has schizophrenia diagnosed according to DSM-5™ The patient has his or her first formal diagnosis of schizophrenia less than 10 years ago The patient has been prescribed outpatient oral antipsychotic treatment at recommended dose range as stated in the Summary of product characteristics or equivalent document/label for the full 3 months prior to the Screening Visit. The patient has CGI-S score of 3 (mildly ill) or 4 (moderately ill) at the Screening and Baseline Visits. The patient has a Global Assessment Scale (GAS) score of 41 to 70 (limits included) at the Screening and Baseline Visits. The patient is in need of a change in the current antipsychotic treatment due to insufficient functional improvement and, in the judgement of the investigator, would benefit from a switch to another treatment. Reasons for switching include but are not limited to the following reasons: lack of adequate response to his or her current antipsychotic medication, poor tolerability to his or her current antipsychotic medication, unwillingness of the patient to adhere to his or her current antipsychotic medication. Exclusion Criteria: The patient has a psychiatric disorder (DSM-5™ criteria) other than schizophrenia established as the primary diagnosis. The patient is experiencing acute exacerbation of psychotic symptoms at the Screening Visit, between the Screening and Baseline Visits or at the Baseline Visit. The patient is hospitalised for his or her psychotic symptoms at the Screening Visit, between the Screening and Baseline Visits or at the Baseline Visit. The patient is treated with brexpiprazole, risperidone or clozapine at the time of Screening Visit. The patient has shown, in the investigator's judgment, significant lack of efficacy to brexpiprazole, risperidone or paliperidone when treated at recommended dose range as stated in their respective Summary of product characteristics or equivalent document/ label, in a manner that would preclude benefiting from the study medication if randomised to brexpiprazole or risperidone during the study. The patient is considered resistant to antipsychotic treatment according to the investigator's judgement. The patient is at significant risk of harming himself/herself, or others according to the investigator's judgement or based on the Columbia Suicide Severity Rating Scale (C-SSRS).
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Email contact via H. Lundbeck A/S
    Organizational Affiliation
    LundbeckClinicalTrials@Lundbeck.com
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    Comparison of the Effectiveness of Brexpiprazole With That of Risperidone

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