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Effect of MMFS-202-302 on Cognitive Enhancement in Schizophrenia

Primary Purpose

Schizophrenia, Schizoaffective Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
MMFS-202-302
Placebo
Sponsored by
Northwestern University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring Schizophrenia, Schizoaffective disorder, Cognition, Magnesium, Imaging, Negative symptoms

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. All patients must be capable of giving written informed consent.
  2. Male or female subjects of any race; between 18 to 60 years of age, inclusive.
  3. No hospitalization other than for evaluation in the past four months
  4. Resides in a stable living situation, according to the investigator's judgment.
  5. Diagnosis of schizophrenia or schizoaffective disorder of at least one-year duration, as established by the SCID-I, and verified with medical records and/or confirmation of diagnosis by treating clinician. The illness is in a nonacute phase as determined by the subject's primary treating clinician
  6. Current psychotropic drug treatment consists of monotherapy with an atypical antipsychotic drug.
  7. No more than a mild level of EPS as determined by the Simpson Angus Scale (SAS) total score: ≤ 6
  8. Not taking anticholinergic medication for EPS
  9. No evidence of tardive dykinesia
  10. Subjects healthy enough to complete a 9-week clinical trial
  11. Women of childbearing potential must have a negative pregnancy test at screening and baseline, and agree to use adequate protection (i.e. double barrier method) for birth control.
  12. Able to complete cognition assessments in English
  13. General intellectual abilities falling broadly within the average estimated IQ > 80, as measured by the Wide Range Achievement Test - 4th Edition (WRAT-IV).

Exclusion Criteria:

  1. Failure to perform screening or baseline examinations
  2. Hospitalization within 8 weeks before screening, or change of antipsychotic medication or dose within 2 months prior to screening
  3. Subjects who have participated in another clinical trial with an experimental medication within the past 2 months.
  4. Patient has had cognitive battery similar to those used in this study within the last 12 months
  5. Subjects with other DSM-V Axis I or Axis II primary diagnoses
  6. Diagnosis of alcohol or substance abuse or dependence within the past 3 months,
  7. Significant suicide risk as determined by the Columbia Suicide Severity Rating Scale (C-SSRS)
  8. Subjects who plan to begin a new course of cognitive remediation therapy, or have been receiving cognitive remediation therapy for less than one year. .
  9. History of myocardial infarction, unstable angina, uncontrolled hypotension or hypertension within 3 months before screening.
  10. Clinically significant abnormality on screening ECG
  11. Alanine transaminase (ALT) or aspartate transaminase (AST) > 2.5 times the upper limit of normal (ULN)
  12. History of stroke, brain tumor, head trauma with loss of consciousness, or other clinically significant neurological condition within 12 months before screening
  13. Subjects with other uncontrolled medical conditions, in the opinion of the investigator
  14. Polypharmacy with two or more antipsychotic drugs or mood stabilizers
  15. Use of benzodiazepines
  16. Individuals with kidney dysfunction will not be enrolled, as dysfunctional kidneys may have difficulty clearing the magnesium from the body
  17. Individuals who are currently taking magnesium supplements

Sites / Locations

  • Northwestern University Psychiatric Clinical Research Program

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

MMFS-202 -302

Placebo

Arm Description

MMFS-202: evening dose MMFS-302: morning dose

Placebo

Outcomes

Primary Outcome Measures

Matrics Consensus Cognitive Battery (MCCB)
Change from Baseline in MATRICS Consensus Cognitive Battery (MCCB) working memory domain.

Secondary Outcome Measures

Overall clinical global impression of severity improvement measured by the Clinical Global Impressions Scale assessment of change (CGI-C)
To support the primary endpoint of working memory, the CGI-C will demonstrate clinically relevant improvement of global function.

Full Information

First Posted
September 9, 2014
Last Updated
August 31, 2017
Sponsor
Northwestern University
Collaborators
Neurocentria, Inc., Brain & Behavior Research Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT02237235
Brief Title
Effect of MMFS-202-302 on Cognitive Enhancement in Schizophrenia
Official Title
Effect of MMFS-202-302 on Cognitive Enhancement in Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Completed
Study Start Date
August 2014 (undefined)
Primary Completion Date
August 2017 (Actual)
Study Completion Date
August 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Northwestern University
Collaborators
Neurocentria, Inc., Brain & Behavior Research Foundation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The goals of this study are to study MMFS-202-302 in a double blind, randomized, placebo-controlled 9-week study of its effect on ameliorating cognitive deficits in 60 patients with schizophrenia or schizoaffective disorder with stable levels of positive symptoms. Secondary end points will include changes in positive and negative symptoms. One dose of MMFS-202-302 will be studied and compared with placebo as adjunctive treatment to atypical antipsychotic drug treatment.
Detailed Description
One of the symptoms of schizophrenia is a problem with specific domains of cognition, even when the positive symptoms have been treated. The primary goal of this study is to determine the effectiveness of 9 weeks of supplementation with MMFS-202-302 as augmentation of atypical antipsychotic medication, to improve a critical specific domain of cognitive function, i.e., working memory, in patients with schizophrenia or schizoaffective disorder. To support this primary goal, global function will be assessed with the Clinical Global Impression assessment of change. The investigators will also examine the effect of MMFS-202-302 on other domains of cognition (e.g. attention, executive function, declarative memory, etc.); negative symptoms of schizophrenia; positive symptoms of schizophrenia; MRI measures of brain structure, resting state functional connectivity, and function during evaluation of emotional/unemotional and rewarding/aversive images and anticipation and receipt of reward and punishment, and working memory; and EEG measurement of network interactivity during learning and memory recollection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia, Schizoaffective Disorder
Keywords
Schizophrenia, Schizoaffective disorder, Cognition, Magnesium, Imaging, Negative symptoms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MMFS-202 -302
Arm Type
Experimental
Arm Description
MMFS-202: evening dose MMFS-302: morning dose
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
MMFS-202-302
Intervention Description
Active ingredient: L-Threonic acid Magnesium salt. 1 g (2 pills) by mouth once daily in the evening for 9 weeks Drug: MMFS-302 Active ingredient: L-Threonic Acid Magnesium Salt 1 g (2 pills) by mouth once daily in the morning for 9 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Two tablets by mouth in the morning, and two tablets by mouth in the evening, daily for 9 weeks.
Primary Outcome Measure Information:
Title
Matrics Consensus Cognitive Battery (MCCB)
Description
Change from Baseline in MATRICS Consensus Cognitive Battery (MCCB) working memory domain.
Time Frame
Baseline to Day 63
Secondary Outcome Measure Information:
Title
Overall clinical global impression of severity improvement measured by the Clinical Global Impressions Scale assessment of change (CGI-C)
Description
To support the primary endpoint of working memory, the CGI-C will demonstrate clinically relevant improvement of global function.
Time Frame
Day 63
Other Pre-specified Outcome Measures:
Title
Change from Baseline in cognition measured by the MATRICS Consensus Cognitive Battery (MCCB) total score
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the MATRICS Consensus Cognitive Battery (MCCB) speed of processing domain subscale score
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the MATRICS Consensus Cognitive Battery (MCCB) attention/vigilance domain subscale score
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the MATRICS Consensus Cognitive Battery (MCCB) verbal learning domain subscale score
Time Frame
Baseline to Days 42 and 63
Title
Change from Baseline in cognition measured by the MATRICS Consensus Cognitive Battery (MCCB) visual learning domain subscale score
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the MATRICS Consensus Cognitive Battery (MCCB) reasoning and problem solving domain subscale score
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the MATRICS Consensus Cognitive Battery (MCCB) social cognition domain subscale score
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the FAS Phonemic Fluency test
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the Brown-Peterson's Auditory Consonant Trigrams test
Time Frame
Baseline through Day 63
Title
Change from Baseline in cognitive outcomes among subgroups of subjects with deficits in the respective cognitive domain
Description
Cognitive outcomes will be reanalyzed, restricted to the subgroup of subjects whose baseline score is at or below median for healthy age-matched norms (T-score of 50 or below) for the respective cognitive outcome of interest. Analogous analyses will be carried out using more conservative cutoffs of one half and one standard deviation below median (T-score of 45 and 40 or below).
Time Frame
Baseline to Day 63
Title
Change from Baseline in cognition measured by the Wisconsin Card Sorting Test
Time Frame
Baseline to Day 63
Title
Change from Baseline in working memory composite score
Time Frame
Baseline to Day 63
Title
Change from Baseline in Negative symptoms measured by the Brief Negative Symptom Scale (BNSS)
Time Frame
Baseline to Day 63
Title
Change from Baseline in Negative symptoms measured by the Positive and Negative Syndrome Scale (PANSS) negative symptom subscale
Time Frame
Baseline to Day 63
Title
Change from Baseline in Negative symptoms measured by the Calgary Depression Scale for Schizophrenia (CDSS)
Time Frame
Baseline to Day 63
Title
Change from Baseline in Positive symptoms measured by the Positive and Negative Syndrome Scale (PANSS) positive symptom subscale
Time Frame
Baseline to Days 42 and 63
Title
Overall clinical global impression of severity improvement measured by the change from Baseline of Clinical Global Impressions Scale assessment of severity (CGI-S)
Time Frame
Baseline to Day 63
Title
Change from Baseline in brain structure and function
Description
Magnetic Resonance Imaging (MRI) measures of brain structure; resting state functional connectivity; and activation patterns during performance of a working memory paradigm, and of brain reward networks during affective/neutral image appraisal and reward/loss anticipation and outcome (regions of interest: OMPFC, ACC, NAc, VTA).
Time Frame
Baseline to Day 63
Title
Change from Baseline neural activity and connectivity during learning and memory recollection measured by EEG
Time Frame
Baseline to Day 63
Title
Change from Baseline of red blood cell magnesium levels in relation to efficacy outcome measures
Description
Red blood cell magnesium level will be evaluated as a putative surrogate biomarker of target engagement, as a predictor of efficacy.
Time Frame
Baseline to Day 63
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
To evaluate safety and tolerability of MMFS-202-302 in patients with schizophrenia or schizoaffective disorder maintained on a stable dose of an atypical antipsychotic, each grade of adverse event will be evaluated individually, as well as the total number of all grades of adverse events
Time Frame
Baseline through Day 63, or Early Termination
Title
Responder analyses
Description
The number of subjects achieving a cutoff of improving at least one half of a standard deviation (T-score change > 5) on the working memory subscale of the MCCB will be compared between the MMFS-202-302 and Placebo groups. Analogous responder analyses will be carried out for other efficacy outcomes.
Time Frame
Baseline to Day 63

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All patients must be capable of giving written informed consent. Male or female subjects of any race; between 18 to 60 years of age, inclusive. No hospitalization other than for evaluation in the past four months Resides in a stable living situation, according to the investigator's judgment. Diagnosis of schizophrenia or schizoaffective disorder of at least one-year duration, as established by the SCID-I, and verified with medical records and/or confirmation of diagnosis by treating clinician. The illness is in a nonacute phase as determined by the subject's primary treating clinician Current psychotropic drug treatment consists of monotherapy with an atypical antipsychotic drug. No more than a mild level of EPS as determined by the Simpson Angus Scale (SAS) total score: ≤ 6 Not taking anticholinergic medication for EPS No evidence of tardive dykinesia Subjects healthy enough to complete a 9-week clinical trial Women of childbearing potential must have a negative pregnancy test at screening and baseline, and agree to use adequate protection (i.e. double barrier method) for birth control. Able to complete cognition assessments in English General intellectual abilities falling broadly within the average estimated IQ > 80, as measured by the Wide Range Achievement Test - 4th Edition (WRAT-IV). Exclusion Criteria: Failure to perform screening or baseline examinations Hospitalization within 8 weeks before screening, or change of antipsychotic medication or dose within 2 months prior to screening Subjects who have participated in another clinical trial with an experimental medication within the past 2 months. Patient has had cognitive battery similar to those used in this study within the last 12 months Subjects with other DSM-V Axis I or Axis II primary diagnoses Diagnosis of alcohol or substance abuse or dependence within the past 3 months, Significant suicide risk as determined by the Columbia Suicide Severity Rating Scale (C-SSRS) Subjects who plan to begin a new course of cognitive remediation therapy, or have been receiving cognitive remediation therapy for less than one year. . History of myocardial infarction, unstable angina, uncontrolled hypotension or hypertension within 3 months before screening. Clinically significant abnormality on screening ECG Alanine transaminase (ALT) or aspartate transaminase (AST) > 2.5 times the upper limit of normal (ULN) History of stroke, brain tumor, head trauma with loss of consciousness, or other clinically significant neurological condition within 12 months before screening Subjects with other uncontrolled medical conditions, in the opinion of the investigator Polypharmacy with two or more antipsychotic drugs or mood stabilizers Use of benzodiazepines Individuals with kidney dysfunction will not be enrolled, as dysfunctional kidneys may have difficulty clearing the magnesium from the body Individuals who are currently taking magnesium supplements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Herbert Y Meltzer, MD
Organizational Affiliation
Northwestern University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Northwestern University Psychiatric Clinical Research Program
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States

12. IPD Sharing Statement

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Effect of MMFS-202-302 on Cognitive Enhancement in Schizophrenia

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