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Dexmedetomidine in the Treatment of Agitation Associated With Schizophrenia (SERENITY I)

Primary Purpose

Agitation, Schizophrenia, Schizo Affective Disorder

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Sublingual film containing dexmedetomidine (BXCL501)
Placebo Film
Sponsored by
BioXcel Therapeutics Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Agitation

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

A subject will be eligible for inclusion in the study if he or she meets the following criteria:

  1. Male and female patients between the ages of 18 to 75 years, inclusive.
  2. Patients who have met DSM-5 criteria for schizophrenia, schizoaffective, or schizophreniform disorder.
  3. Patients who are judged to be clinically agitated at Screening and Baseline with a total score of ≥ 14 on the 5 items (poor impulse control, tension, hostility, uncooperativeness, and excitement) comprising the PANSS Excited Component (PEC).
  4. Patients who have a score of ≥ 4 on at least 1 of the 5 items on the PEC at Baseline.
  5. Patients who read, understand, and provide written informed consent.
  6. Patients who are in good general health prior to study participation as determined by a detailed medical history, physical examination, 12-lead ECG with rhythm strip, blood chemistry profile, hematology, urinalysis, and in the opinion of the Principal Investigator.
  7. Participants who agree to use a medically acceptable and effective birth control method

Exclusion Criteria:

A subject will be excluded from the study if he or she meets the following criteria:

  1. Patients with agitation caused by acute intoxication, including positive identification of alcohol by breathalyzer or drugs of abuse (with the exception of THC) during urine screening.
  2. Use of benzodiazepines, hypnotics and anti-psychotic drugs in the 4 hours before study treatment.
  3. Treatment with alpha-1 noradrenergic blockers (terazosin, doxazosin, tamsulosin, alfuzosin, or prazosin) or other prohibited medications.
  4. Patients who are judged to be at significant risk of suicide
  5. Female patients who have a positive pregnancy test at screening or are breastfeeding.
  6. Patients who have hydrocephalus, seizure disorder, or history of significant head trauma, stroke, transient ischemic attack, subarachnoid bleeding, brain tumor, encephalopathy, meningitis, Parkinson's disease or focal neurological findings.
  7. History of syncope or other syncopal attacks, current evidence of hypovolemia, orthostatic hypotension.
  8. Patients with laboratory or ECG abnormalities considered clinically significant by the investigator.
  9. Patients with serious or unstable medical illnesses.
  10. Patients who have received an investigational drug within 30 days prior to the current agitation episode.
  11. Patients who are considered by the investigator, for any reason, to be an unsuitable candidate for receiving DEX.

Sites / Locations

  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site
  • BioXcel Clinical Research Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

120 Micrograms

180 Micrograms

Placebo

Arm Description

Sublingual film containing 120 Micrograms dexmedetomidine

Sublingual film containing 180 Micrograms dexmedetomidine

Sublingual placebo film

Outcomes

Primary Outcome Measures

Change From Baseline in the Positive and Negative Syndrome Scale- Excited Component (PEC) Total Score
The Positive and Negative Syndrome Scale-Excited Component (PEC) includes 5 items-poor impulse control, tension, hostility, uncooperativeness, and excitement-each of which is rated from 1 (minimum) to 7 (maximum); the sum of these 5 items, the PEC total score, ranges from 5 (absence of agitation) to 35 (extremely severe).

Secondary Outcome Measures

Change From Baseline in the Positive and Negative Syndrome Scale- Excited Component (PEC) Total Score Over Time
Effect on agitation onset was measured by change from baseline in the Positive and Negative Syndrome Scale- Excited Component (PEC) total score. The Positive and Negative Syndrome Scale-Excited Component (PEC) includes 5 items-poor impulse control, tension, hostility, uncooperativeness, and excitement-each of which is rated from 1 (minimum) to 7 (maximum); the sum of these 5 items, the PEC total score, ranges from 5 (absence of agitation) to 35 (extremely severe).

Full Information

First Posted
February 11, 2020
Last Updated
May 25, 2023
Sponsor
BioXcel Therapeutics Inc
Collaborators
Cognitive Research Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT04268303
Brief Title
Dexmedetomidine in the Treatment of Agitation Associated With Schizophrenia
Acronym
SERENITY I
Official Title
A Phase III Multicenter, Randomized, Double-Blind, Placebo-Controlled Study To Determine Efficacy and Safety of BXCL501 In Agitation Associated With Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
January 24, 2020 (Actual)
Primary Completion Date
May 6, 2020 (Actual)
Study Completion Date
May 6, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioXcel Therapeutics Inc
Collaborators
Cognitive Research Corporation

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 is a definitive study to support the safety and efficacy evaluation of BXCL501 for the acute treatment of agitation in schizophrenia. The BXCL501-301 study is designed to characterize the efficacy, safety and tolerability of BXCL501 (sublingual film formulation of DEX, HCl) in agitation associated with schizophrenia, schizoaffective disorder or schizophreniform disorder.
Detailed Description
The study will enroll approximately 375 subjects randomized 1:1:1 to dose regimens of 180µg, 120µg BXCL501, or placebo. Male and female adults with acute agitation associated with schizophrenia, schizoaffective disorder, or schizophreniform disorder will be enrolled. Eligible subjects may be identified in outpatient clinics, mental health, psychiatric or medical emergency services including medical/psychiatric observation units, or as newly admitted to a hospital setting for acute agitation or already in hospital for chronic underlying conditions. Subjects will be domiciled in a clinical research setting or hospitalized to remain under medical supervision while undergoing screening procedures to assess eligibility. Efficacy and safety assessments will be conducted periodically before and after dosing.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Agitation, Schizophrenia, Schizo Affective Disorder, Schizoaffective Disorder, Schizophreniform Disorders

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Phase III, Randomized, Double-Blind, Placebo-Controlled
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Double-Blind, Placebo-Controlled
Allocation
Randomized
Enrollment
380 (Actual)

8. Arms, Groups, and Interventions

Arm Title
120 Micrograms
Arm Type
Experimental
Arm Description
Sublingual film containing 120 Micrograms dexmedetomidine
Arm Title
180 Micrograms
Arm Type
Experimental
Arm Description
Sublingual film containing 180 Micrograms dexmedetomidine
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Sublingual placebo film
Intervention Type
Drug
Intervention Name(s)
Sublingual film containing dexmedetomidine (BXCL501)
Other Intervention Name(s)
Dexmedetomidine
Intervention Description
Sublingual film containing dexmedetomidine (BXCL501)
Intervention Type
Drug
Intervention Name(s)
Placebo Film
Other Intervention Name(s)
Placebo
Intervention Description
Placebo Film for BXCL501
Primary Outcome Measure Information:
Title
Change From Baseline in the Positive and Negative Syndrome Scale- Excited Component (PEC) Total Score
Description
The Positive and Negative Syndrome Scale-Excited Component (PEC) includes 5 items-poor impulse control, tension, hostility, uncooperativeness, and excitement-each of which is rated from 1 (minimum) to 7 (maximum); the sum of these 5 items, the PEC total score, ranges from 5 (absence of agitation) to 35 (extremely severe).
Time Frame
Baseline and 2 hours
Secondary Outcome Measure Information:
Title
Change From Baseline in the Positive and Negative Syndrome Scale- Excited Component (PEC) Total Score Over Time
Description
Effect on agitation onset was measured by change from baseline in the Positive and Negative Syndrome Scale- Excited Component (PEC) total score. The Positive and Negative Syndrome Scale-Excited Component (PEC) includes 5 items-poor impulse control, tension, hostility, uncooperativeness, and excitement-each of which is rated from 1 (minimum) to 7 (maximum); the sum of these 5 items, the PEC total score, ranges from 5 (absence of agitation) to 35 (extremely severe).
Time Frame
Baseline and 10, 20, 30, 45, 60, 90 minutes post-dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A subject will be eligible for inclusion in the study if he or she meets the following criteria: Male and female patients between the ages of 18 to 75 years, inclusive. Patients who have met DSM-5 criteria for schizophrenia, schizoaffective, or schizophreniform disorder. Patients who are judged to be clinically agitated at Screening and Baseline with a total score of ≥ 14 on the 5 items (poor impulse control, tension, hostility, uncooperativeness, and excitement) comprising the PANSS Excited Component (PEC). Patients who have a score of ≥ 4 on at least 1 of the 5 items on the PEC at Baseline. Patients who read, understand, and provide written informed consent. Patients who are in good general health prior to study participation as determined by a detailed medical history, physical examination, 12-lead ECG with rhythm strip, blood chemistry profile, hematology, urinalysis, and in the opinion of the Principal Investigator. Participants who agree to use a medically acceptable and effective birth control method Exclusion Criteria: A subject will be excluded from the study if he or she meets the following criteria: Patients with agitation caused by acute intoxication, including positive identification of alcohol by breathalyzer or drugs of abuse (with the exception of THC) during urine screening. Use of benzodiazepines, hypnotics and anti-psychotic drugs in the 4 hours before study treatment. Treatment with alpha-1 noradrenergic blockers (terazosin, doxazosin, tamsulosin, alfuzosin, or prazosin) or other prohibited medications. Patients who are judged to be at significant risk of suicide Female patients who have a positive pregnancy test at screening or are breastfeeding. Patients who have hydrocephalus, seizure disorder, or history of significant head trauma, stroke, transient ischemic attack, subarachnoid bleeding, brain tumor, encephalopathy, meningitis, Parkinson's disease or focal neurological findings. History of syncope or other syncopal attacks, current evidence of hypovolemia, orthostatic hypotension. Patients with laboratory or ECG abnormalities considered clinically significant by the investigator. Patients with serious or unstable medical illnesses. Patients who have received an investigational drug within 30 days prior to the current agitation episode. Patients who are considered by the investigator, for any reason, to be an unsuitable candidate for receiving DEX.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Risinger, MD
Organizational Affiliation
BioXcel Therapeutics
Official's Role
Study Chair
Facility Information:
Facility Name
BioXcel Clinical Research Site
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72211
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Cerritos
State/Province
California
ZIP/Postal Code
78754
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Culver City
State/Province
California
ZIP/Postal Code
90230
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Miami Lakes
State/Province
Florida
ZIP/Postal Code
33016
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60640
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Gaithersburg
State/Province
Maryland
ZIP/Postal Code
20877
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89102
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Berlin
State/Province
New Jersey
ZIP/Postal Code
08009
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Marlton
State/Province
New Jersey
ZIP/Postal Code
08053
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29407
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Austin
State/Province
Texas
ZIP/Postal Code
78754
Country
United States
Facility Name
BioXcel Clinical Research Site
City
DeSoto
State/Province
Texas
ZIP/Postal Code
75115
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Richardson
State/Province
Texas
ZIP/Postal Code
75080
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36198061
Citation
Citrome L, Preskorn SH, Lauriello J, Krystal JH, Kakar R, Finman J, De Vivo M, Yocca FD, Risinger R, Rajachandran L. Sublingual Dexmedetomidine for the Treatment of Acute Agitation in Adults With Schizophrenia or Schizoaffective Disorder: A Randomized Placebo-Controlled Trial. J Clin Psychiatry. 2022 Oct 3;83(6):22m14447. doi: 10.4088/JCP.22m14447.
Results Reference
derived
PubMed Identifier
36002761
Citation
Citrome L, Risinger R, Rajachandran L, Robison H. Sublingual Dexmedetomidine for Agitation Associated with Schizophrenia or Bipolar Disorder: A Post Hoc Analysis of Number Needed to Treat, Number Needed to Harm, and Likelihood to be Helped or Harmed. Adv Ther. 2022 Oct;39(10):4821-4835. doi: 10.1007/s12325-022-02274-3. Epub 2022 Aug 24. Erratum In: Adv Ther. 2023 Jan;40(1):391.
Results Reference
derived
Links:
URL
https://www.psychiatrist.com/jcp/schizophrenia/sublingual-dexmedetomidine-for-agitation-schizophrenia/
Description
Journal Article

Learn more about this trial

Dexmedetomidine in the Treatment of Agitation Associated With Schizophrenia

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