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Study to Evaluate TV-46000 as Maintenance Treatment in Adult and Adolescent Participants With Schizophrenia (RISE)

Primary Purpose

Schizophrenia

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
TV-46000
Placebo
Sponsored by
Teva Branded Pharmaceutical Products R&D, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia

Eligibility Criteria

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

Inclusion Criteria:

  • The participant has a diagnosis of schizophrenia for >1 year and has had ≥1 episode of relapse in the last 24 months.
  • The participant has been responsive to an antipsychotic treatment (other than clozapine) in the past year based on discussions with family members or healthcare professionals.
  • The participant has a stable place of residence for the previous 3 months before screening, and changes in residence are not anticipated over the course of study participation.
  • The participant has no significant life events that could affect study outcomes expected throughout the period of study participation.
  • Women of childbearing potential and sexually-active female adolescents must agree not to try to become pregnant, and, unless they have exclusively same-sex partners, must agree to use a highly effective method of contraception, and agree to continue use of this method beginning 1 month before the first administration of study drugs and for the duration of the study and for 120 days after the last injection of study drug.
  • The participant, if adult or adolescent male, is surgically sterile, or, if capable of producing offspring, or has exclusively same-sex partners or is currently using an approved method of birth control and agrees to the continued use of this method for the duration of the study (and for 120 days after the last dose of study drug). Male participants with sex partners who are women of childbearing potential must use condoms even if surgically sterile

    • Additional criteria apply, please contact the investigator for more information

Exclusion Criteria:

  • The participant has a current clinically significant Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnosis other than schizophrenia, including schizoaffective disorder, major depressive disorder, bipolar disorder, delirium, dementia, or amnestic or other cognitive disorders, or borderline, paranoid, histrionic, schizotypal, schizoid, or antisocial personality disorder.
  • The participant is currently on clozapine or received electroconvulsive therapy in the last 12 months.
  • The participant has a history of epilepsy or seizures, neuroleptic malignant syndrome, tardive dyskinesia, or other medical condition that would expose the participant to undue risk.
  • The participant has a positive serology for human immunodeficiency virus (HIV)-1, HIV-2, hepatitis B surface antigen, and/or hepatitis C.
  • The participant has current or history of known hypersensitivity to risperidone or any of the excipients of TV-46000 or the oral formulation of risperidone used in the stabilization phase.
  • The participant has a substance use disorder, including alcohol and benzodiazepines but excluding nicotine and caffeine.
  • The participant has previously participated in a Teva-sponsored clinical study with TV-46000.
  • The participant is a pregnant or lactating female.
  • The participant has any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (including gastrointestinal surgery).
  • The participant has used an investigational drug within 3 months prior to screening or has participated in a non-drug clinical trial within 30 days prior to screening.

    • Additional criteria apply, please contact the investigator for more information

Sites / Locations

  • Teva Investigational Site 14769
  • Teva Investigational Site 14796
  • Teva Investigational Site 14811
  • Teva Investigational Site 14794
  • Teva Investigational Site 14776
  • Teva Investigational Site 14767
  • Teva Investigational Site 14802
  • Teva Investigational Site 14773
  • Teva Investigational Site 14835
  • Teva Investigational Site 14774
  • Teva Investigational Site 14817
  • Teva Investigational Site 14771
  • Teva Investigational Site 14823
  • Teva Investigational Site 14816
  • Teva Investigational Site 14803
  • Teva Investigational Site 14786
  • Teva Investigational Site 14797
  • Teva Investigational Site 14827
  • Teva Investigational Site 14777
  • Teva Investigational Site 14815
  • Teva Investigational Site 14812
  • Teva Investigational Site 14785
  • Teva Investigational Site 14818
  • Teva Investigational Site 14828
  • Teva Investigational Site 14819
  • Teva Investigational Site 14779
  • Teva Investigational Site 14788
  • Teva Investigational Site 14768
  • Teva Investigational Site 14783
  • Teva Investigational Site 14836
  • Teva Investigational Site 14787
  • Teva Investigational Site 14814
  • Teva Investigational Site 14799
  • Teva Investigational Site 14832
  • Teva Investigational Site 14810
  • Teva Investigational Site 14831
  • Teva Investigational Site 14806
  • Teva Investigational Site 14837
  • Teva Investigational Site 14824
  • Teva Investigational Site 14834
  • Teva Investigational Site 14821
  • Teva Investigational Site 14770
  • Teva Investigational Site 14765
  • Teva Investigational Site 14829
  • Teva Investigational Site 14805
  • Teva Investigational Site 14825
  • Teva Investigational Site 14764
  • Teva Investigational Site 14820
  • Teva Investigational Site 14798
  • Teva Investigational Site 14791
  • Teva Investigational Site 14813
  • Teva Investigational Site 14826
  • Teva Investigational Site 14790
  • Teva Investigational Site 14809
  • Teva Investigational Site 14792
  • Teva Investigational Site 14830
  • Teva Investigational Site 14772
  • Teva Investigational Site 14804
  • Teva Investigational Site 14800
  • Teva Investigational Site 14784
  • Teva Investigational Site 14780
  • Teva Investigational Site 14763
  • Teva Investigational Site 14782
  • Teva Investigational Site 14822
  • Teva Investigational Site 14789
  • Teva Investigational Site 14833
  • Teva Investigational Site 14775
  • Teva Investigational Site 14793
  • Teva Investigational Site 14778
  • Teva Investigational Site 14781
  • Teva Investigational Site 14766
  • Teva Investigational Site 14801
  • Teva Investigational Site 14807
  • Teva Investigational Site 59148
  • Teva Investigational Site 59152
  • Teva Investigational Site 59151
  • Teva Investigational Site 59149
  • Teva Investigational Site 59144
  • Teva Investigational Site 59154
  • Teva Investigational Site 59150
  • Teva Investigational Site 59146

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Placebo

TV-46000 q1m

TV-46000 q2m

Arm Description

Participants will receive an SC injection of placebo matching to TV-46000 at baseline and every 4 weeks (q4w) thereafter. Participants will continue treatment until they experience a relapse event; meet 1 or more of the study discontinuation or withdrawal criteria; or remain relapse-free during the double-blind phase until the study is terminated.

Participants will receive an SC injection of TV-46000 at baseline and q4w thereafter. The maximal dose for adult participants is comparable to an oral risperidone dose of 5 milligrams (mg)/day, and the maximal dose for adolescents is comparable to 4 mg/day. Participants will continue treatment until they experience a relapse event; meet 1 or more of the study discontinuation or withdrawal criteria; or remain relapse-free during the double-blind phase until the study is terminated.

Participants will receive an SC injection of TV-46000 at baseline and every 8 weeks (q8w) thereafter, and a placebo SC injection 4 weeks after baseline and q8w thereafter. The maximal dose for adult participants is comparable to an oral risperidone dose of 5 mg/day, and the maximal dose for adolescents is comparable to 4 mg/day. Participants will continue treatment until they experience a relapse event; meet 1 or more of the study discontinuation or withdrawal criteria; or remain relapse-free during the double-blind phase until the study is terminated.

Outcomes

Primary Outcome Measures

Time to Impending Relapse (Number of Participants With Impending Relapse) for Intent-to-treat [ITT] Analysis Set
Relapse was defined as 1 or more of the following items: • Clinical Global Impression-Improvement (CGI-I) of ≥5, and - an increase of any of the 4 Positive and Negative Syndrome Scale (PANSS) items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • Clinical Global Impression-Severity of Suicidality (CGI-SS) of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Data is presented as distribution of relapsing participants (number of participants with impending relapse).

Secondary Outcome Measures

Time to Impending Relapse (Number of Participants With Impending Relapse) for Extended ITT [eITT] Analysis Set
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Data is presented as distribution of relapsing participants (adults and adolescents) (number of participants with impending relapse).
Proportion of Participants With Impending Relapse
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Impending relapse rate at Week 24 was estimated using the Kaplan-Meier product estimate.
Number of Participants Who Maintain Stability at the Endpoint
Stability is defined as meeting all of the following criteria for at least 4 consecutive weeks: outpatient status; PANSS total score ≤80; minimal presence of specific psychotic symptoms on the PANSS, as measured by a score of ≤4 on each of the following items: conceptual disorganization, suspiciousness, hallucinatory behavior, and unusual thought content; Clinical Global Impression of Severity (CGI-S) score ≤4 (moderately ill); and CGI-SS score ≤2 (mildly suicidal) on Part 1 and ≤5 (minimally worsened) on Part 2. The last valid participant assessment was used as the endpoint.
Number of Participants Achieving Remission at the Endpoint
The remission was achieved for participants who did not relapse during the study and for over a period of at least 6 months preceding the endpoint, maintained scores of = 3 on each of the 8 specific PANSS items: P1 (delusions), G9 (unusual thought content), P3 (hallucinatory behavior), P2 (conceptual disorganization), G5 (mannerisms/posturing), N1 (blunted affect), N4 (social withdrawal), and N6 (lack of spontaneity). The last valid participant assessment was used as the endpoint.
Observed Rate of Impending Relapse (Number of Participants With Impending Relapse) at the Endpoint
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Observed rate of impending relapse was calculated as the number of participants who relapsed by endpoint divided by the number of participants in each treatment group, using the last valid participant assessment as the endpoint.
Time to Impending Relapse (Number of Participants With Impending Relapse) in the Adolescent Participants
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Data is presented as distribution of relapsing participants (adolescents) (number of participants with impending relapse).
Change From Baseline in Drug Attitudes Inventory 10-item Version (DAI-10) Total Score at the Endpoint and End of Treatment
The DAI-10 is a 10-item questionnaire to assess 1) subjective experience of drug and 2) attitudes and beliefs toward neuroleptics which may influence compliance in schizophrenia participants. The DAI-10 contains 6 items (1, 3, 4, 7, 9, and 10) that a participant who was fully adherent to the prescribed medication answered as "True" and 4 items (2, 5, 6, and 8) that a participant who was fully adherent to the prescribed medication answered as "False." A correct answer was scored +1 and an incorrect answer was scored -1. The total score was the sum of pluses and minuses, which ranged from -10 to 10 in increments of 2. A positive total score indicated a positive subjective response (compliant) and a negative total score indicated a negative subjective response (non-compliance). Higher scores denoted better compliance. The last valid participant assessment was used as the endpoint.
Change From Baseline in Schizophrenia Quality of Life Scale (SQLS) Total Score at the Endpoint and End of Treatment
The SQLS comprises 33 items categorized in 2 domains: psychosocial feelings (20 items) and cognition and vitality (13 items). The items were scored on a 5-point scale (1 - never, 2 - rarely, 3 - sometimes, 4 - often, 5 - always). Individual domain and total scores were standardized by scoring algorithm to a 0 (best health status) to 100 (worst health status) scale, with higher scores indicating comparatively lower quality of life. The last valid participant assessment was used as the endpoint.
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
An adverse event (AE) was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs were defined as AEs occurring after the first dose of the study drug until 120 days after the last dose of study drug. Serious AEs were defined as death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
Change From Baseline in Total Abnormal Involuntary Movement Scale (AIMS) Score at the End of Treatment
The AIMS is a 14-item scale that includes assessments of orofacial movements, extremity and truncal dyskinesia, examiner's judgment of global severity, subjective measures of awareness of movements and distress, and a yes/no assessment of problems concerning teeth and/or dentures. Total AIMS score is a sum of item 1 through 7. Items 1 through 7 include facial and oral movements (Items 1-4), extremity movements (Items 5-6), and trunk movements (Item 7). Each item was rated on a 0 (no dyskinesia) to 4 (severe dyskinesia) scale. Total AIMS score for Items 1-7 ranged from 0 to 28; with higher scores indicating greater severity of the condition.
Change From Baseline in Simpson-Angus Scale (SAS) Mean Score at the End of Treatment
The SAS is a 10-item instrument for the assessment of neuroleptic-induced parkinsonism. The items on the scale include measurements of hypokinesia, rigidity, glabellar reflex, tremor, and salivation. Each item was rated on a 5-point scale (0 [None/Normal] to 4 [Extreme/Severe]). The mean score was calculated by adding the individual item scores and dividing by 10. The total mean score ranged from 0-4, with a higher score indicating greater severity of symptoms.
Change From Baseline in Total Barnes Akathisia Rating Scale (BARS) Score at the End of Treatment
The BARS is an instrument that assesses the severity of drug-induced akathisia. The BARS includes 3 items for rating objective restless movements, subjective restlessness, and any subjective distress associated with akathisia that were scored on a 4-point scale of 0 (normal/no distress) to 3 (constant restlessness/severe distress). Total score was the sum of scores of each item and ranged from 0-9, with higher scores indicating greater severity of akathisia.
Number of Participants Reporting Suicidal Behavior and Suicidal Ideation Using Columbia-Suicide Severity Rating Scale (C-SSRS) at Baseline and Post-Baseline
The C-SSRS is a semi-structured interview that captures the occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal behavior was defined as a "yes" answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide. Suicidal ideation was defined as a "yes" answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation.
Change From Baseline in Calgary Depression Scale for Schizophrenia (CDSS) Score at the End of Treatment
The CDSS is specifically designed to assess the level of depression separate from the positive, negative, and EPS in schizophrenia. This clinician-administered instrument consists of 9 items, each rated on a 4-point scale from 0 (absent) to 3 (severe) that were added together to form the total CDSS depression score of the participant. The total score ranged from 0-27, with higher scores indicating greater severity of the condition.
Change From Baseline in Clinical Global Impression-Severity of Suicidality (CGI-SS) Score at the End of Treatment
The CGI-SS scale provides an overall clinician-rated assessment of the risk of suicidality. The CGI-SS consists of a 5-point scale in Part 1 (the most severe level of suicidality experience) ranging from 1 (not at all suicidal) to 5 (attempted suicide) and a 7-point scale in Part 2 (change in participant suicidality) ranging from 1 (very much improved) to 7 (very much worse).
Plasma Concentration of Risperidone, 9-OH-risperidone, and Total Active Moiety (Sum of Risperidone and 9-OH-risperidone)

Full Information

First Posted
April 9, 2018
Last Updated
February 8, 2023
Sponsor
Teva Branded Pharmaceutical Products R&D, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03503318
Brief Title
Study to Evaluate TV-46000 as Maintenance Treatment in Adult and Adolescent Participants With Schizophrenia
Acronym
RISE
Official Title
A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy, Safety, and Tolerability of Risperidone Extended-Release Injectable Suspension (TV-46000) for Subcutaneous Use as Maintenance Treatment in Adult and Adolescent Patients With Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
April 27, 2018 (Actual)
Primary Completion Date
September 30, 2020 (Actual)
Study Completion Date
December 3, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Teva Branded Pharmaceutical Products R&D, Inc.

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
The purpose of the study is to evaluate the efficacy, safety, and tolerability of different dose regimens of TV-46000 administered subcutaneously (SC) as compared to placebo during maintenance treatment in adult and adolescent participants with schizophrenia. The study will include male and female participants, 13 to 65 years of age, who have a confirmed diagnosis of schizophrenia, are clinically stable, and are eligible for risperidone treatment

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
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
544 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive an SC injection of placebo matching to TV-46000 at baseline and every 4 weeks (q4w) thereafter. Participants will continue treatment until they experience a relapse event; meet 1 or more of the study discontinuation or withdrawal criteria; or remain relapse-free during the double-blind phase until the study is terminated.
Arm Title
TV-46000 q1m
Arm Type
Experimental
Arm Description
Participants will receive an SC injection of TV-46000 at baseline and q4w thereafter. The maximal dose for adult participants is comparable to an oral risperidone dose of 5 milligrams (mg)/day, and the maximal dose for adolescents is comparable to 4 mg/day. Participants will continue treatment until they experience a relapse event; meet 1 or more of the study discontinuation or withdrawal criteria; or remain relapse-free during the double-blind phase until the study is terminated.
Arm Title
TV-46000 q2m
Arm Type
Experimental
Arm Description
Participants will receive an SC injection of TV-46000 at baseline and every 8 weeks (q8w) thereafter, and a placebo SC injection 4 weeks after baseline and q8w thereafter. The maximal dose for adult participants is comparable to an oral risperidone dose of 5 mg/day, and the maximal dose for adolescents is comparable to 4 mg/day. Participants will continue treatment until they experience a relapse event; meet 1 or more of the study discontinuation or withdrawal criteria; or remain relapse-free during the double-blind phase until the study is terminated.
Intervention Type
Drug
Intervention Name(s)
TV-46000
Other Intervention Name(s)
Risperidone
Intervention Description
TV-46000 will be administered per dose and schedule specified in the arm.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo matching to TV-46000 will be administered per schedule specified in the arm.
Primary Outcome Measure Information:
Title
Time to Impending Relapse (Number of Participants With Impending Relapse) for Intent-to-treat [ITT] Analysis Set
Description
Relapse was defined as 1 or more of the following items: • Clinical Global Impression-Improvement (CGI-I) of ≥5, and - an increase of any of the 4 Positive and Negative Syndrome Scale (PANSS) items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • Clinical Global Impression-Severity of Suicidality (CGI-SS) of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Data is presented as distribution of relapsing participants (number of participants with impending relapse).
Time Frame
From randomization up to 108 weeks
Secondary Outcome Measure Information:
Title
Time to Impending Relapse (Number of Participants With Impending Relapse) for Extended ITT [eITT] Analysis Set
Description
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Data is presented as distribution of relapsing participants (adults and adolescents) (number of participants with impending relapse).
Time Frame
From randomization up to 108 weeks
Title
Proportion of Participants With Impending Relapse
Description
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Impending relapse rate at Week 24 was estimated using the Kaplan-Meier product estimate.
Time Frame
Week 24
Title
Number of Participants Who Maintain Stability at the Endpoint
Description
Stability is defined as meeting all of the following criteria for at least 4 consecutive weeks: outpatient status; PANSS total score ≤80; minimal presence of specific psychotic symptoms on the PANSS, as measured by a score of ≤4 on each of the following items: conceptual disorganization, suspiciousness, hallucinatory behavior, and unusual thought content; Clinical Global Impression of Severity (CGI-S) score ≤4 (moderately ill); and CGI-SS score ≤2 (mildly suicidal) on Part 1 and ≤5 (minimally worsened) on Part 2. The last valid participant assessment was used as the endpoint.
Time Frame
At the endpoint (up to 108 weeks)
Title
Number of Participants Achieving Remission at the Endpoint
Description
The remission was achieved for participants who did not relapse during the study and for over a period of at least 6 months preceding the endpoint, maintained scores of = 3 on each of the 8 specific PANSS items: P1 (delusions), G9 (unusual thought content), P3 (hallucinatory behavior), P2 (conceptual disorganization), G5 (mannerisms/posturing), N1 (blunted affect), N4 (social withdrawal), and N6 (lack of spontaneity). The last valid participant assessment was used as the endpoint.
Time Frame
At Endpoint (up to 108 weeks)
Title
Observed Rate of Impending Relapse (Number of Participants With Impending Relapse) at the Endpoint
Description
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Observed rate of impending relapse was calculated as the number of participants who relapsed by endpoint divided by the number of participants in each treatment group, using the last valid participant assessment as the endpoint.
Time Frame
At the Endpoint (up to 108 weeks)
Title
Time to Impending Relapse (Number of Participants With Impending Relapse) in the Adolescent Participants
Description
Relapse was defined as 1 or more of the following items: • CGI-I of ≥5, and - an increase of any of the 4 PANSS items: conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content, to a score of >4 with an absolute increase of ≥2 on specific item since randomization, or - an increase in any of the 4 individual PANSS items to a score of >4 and an absolute increase of ≥4 on combined score of 4 items since randomization; • hospitalization due to worsening of psychotic symptoms; • CGI-SS of 4 (severely suicidal) or 5 (attempted suicide) on Part 1 and/or 6 (much worse) or 7 (very much worse) on Part 2; • violent behavior resulting in clinically significant self-injury, injury to another person, or property damage. Data is presented as distribution of relapsing participants (adolescents) (number of participants with impending relapse).
Time Frame
From randomization up to 108 weeks
Title
Change From Baseline in Drug Attitudes Inventory 10-item Version (DAI-10) Total Score at the Endpoint and End of Treatment
Description
The DAI-10 is a 10-item questionnaire to assess 1) subjective experience of drug and 2) attitudes and beliefs toward neuroleptics which may influence compliance in schizophrenia participants. The DAI-10 contains 6 items (1, 3, 4, 7, 9, and 10) that a participant who was fully adherent to the prescribed medication answered as "True" and 4 items (2, 5, 6, and 8) that a participant who was fully adherent to the prescribed medication answered as "False." A correct answer was scored +1 and an incorrect answer was scored -1. The total score was the sum of pluses and minuses, which ranged from -10 to 10 in increments of 2. A positive total score indicated a positive subjective response (compliant) and a negative total score indicated a negative subjective response (non-compliance). Higher scores denoted better compliance. The last valid participant assessment was used as the endpoint.
Time Frame
Baseline, endpoint and end of treatment (up to Week 108)
Title
Change From Baseline in Schizophrenia Quality of Life Scale (SQLS) Total Score at the Endpoint and End of Treatment
Description
The SQLS comprises 33 items categorized in 2 domains: psychosocial feelings (20 items) and cognition and vitality (13 items). The items were scored on a 5-point scale (1 - never, 2 - rarely, 3 - sometimes, 4 - often, 5 - always). Individual domain and total scores were standardized by scoring algorithm to a 0 (best health status) to 100 (worst health status) scale, with higher scores indicating comparatively lower quality of life. The last valid participant assessment was used as the endpoint.
Time Frame
Baseline, endpoint and end of treatment (up to Week 108)
Title
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Description
An adverse event (AE) was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs were defined as AEs occurring after the first dose of the study drug until 120 days after the last dose of study drug. Serious AEs were defined as death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
Time Frame
From randomization up to 120 days after last dose of study drug (up to Week 125)
Title
Change From Baseline in Total Abnormal Involuntary Movement Scale (AIMS) Score at the End of Treatment
Description
The AIMS is a 14-item scale that includes assessments of orofacial movements, extremity and truncal dyskinesia, examiner's judgment of global severity, subjective measures of awareness of movements and distress, and a yes/no assessment of problems concerning teeth and/or dentures. Total AIMS score is a sum of item 1 through 7. Items 1 through 7 include facial and oral movements (Items 1-4), extremity movements (Items 5-6), and trunk movements (Item 7). Each item was rated on a 0 (no dyskinesia) to 4 (severe dyskinesia) scale. Total AIMS score for Items 1-7 ranged from 0 to 28; with higher scores indicating greater severity of the condition.
Time Frame
Baseline, end of treatment (up to 108 weeks)
Title
Change From Baseline in Simpson-Angus Scale (SAS) Mean Score at the End of Treatment
Description
The SAS is a 10-item instrument for the assessment of neuroleptic-induced parkinsonism. The items on the scale include measurements of hypokinesia, rigidity, glabellar reflex, tremor, and salivation. Each item was rated on a 5-point scale (0 [None/Normal] to 4 [Extreme/Severe]). The mean score was calculated by adding the individual item scores and dividing by 10. The total mean score ranged from 0-4, with a higher score indicating greater severity of symptoms.
Time Frame
Baseline, end of treatment (up to 108 weeks)
Title
Change From Baseline in Total Barnes Akathisia Rating Scale (BARS) Score at the End of Treatment
Description
The BARS is an instrument that assesses the severity of drug-induced akathisia. The BARS includes 3 items for rating objective restless movements, subjective restlessness, and any subjective distress associated with akathisia that were scored on a 4-point scale of 0 (normal/no distress) to 3 (constant restlessness/severe distress). Total score was the sum of scores of each item and ranged from 0-9, with higher scores indicating greater severity of akathisia.
Time Frame
Baseline, end of treatment (up to 108 weeks)
Title
Number of Participants Reporting Suicidal Behavior and Suicidal Ideation Using Columbia-Suicide Severity Rating Scale (C-SSRS) at Baseline and Post-Baseline
Description
The C-SSRS is a semi-structured interview that captures the occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal behavior was defined as a "yes" answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide. Suicidal ideation was defined as a "yes" answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation.
Time Frame
Baseline, post-baseline (up to 108 weeks)
Title
Change From Baseline in Calgary Depression Scale for Schizophrenia (CDSS) Score at the End of Treatment
Description
The CDSS is specifically designed to assess the level of depression separate from the positive, negative, and EPS in schizophrenia. This clinician-administered instrument consists of 9 items, each rated on a 4-point scale from 0 (absent) to 3 (severe) that were added together to form the total CDSS depression score of the participant. The total score ranged from 0-27, with higher scores indicating greater severity of the condition.
Time Frame
Baseline, end of treatment (up to 108 weeks)
Title
Change From Baseline in Clinical Global Impression-Severity of Suicidality (CGI-SS) Score at the End of Treatment
Description
The CGI-SS scale provides an overall clinician-rated assessment of the risk of suicidality. The CGI-SS consists of a 5-point scale in Part 1 (the most severe level of suicidality experience) ranging from 1 (not at all suicidal) to 5 (attempted suicide) and a 7-point scale in Part 2 (change in participant suicidality) ranging from 1 (very much improved) to 7 (very much worse).
Time Frame
Baseline, end of treatment (up to 108 weeks)
Title
Plasma Concentration of Risperidone, 9-OH-risperidone, and Total Active Moiety (Sum of Risperidone and 9-OH-risperidone)
Time Frame
1 hour prior to dosing at Baseline (Day 1) and at the end of treatment visit (up to 108 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
13 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The participant has a diagnosis of schizophrenia for >1 year and has had ≥1 episode of relapse in the last 24 months. The participant has been responsive to an antipsychotic treatment (other than clozapine) in the past year based on discussions with family members or healthcare professionals. The participant has a stable place of residence for the previous 3 months before screening, and changes in residence are not anticipated over the course of study participation. The participant has no significant life events that could affect study outcomes expected throughout the period of study participation. Women of childbearing potential and sexually-active female adolescents must agree not to try to become pregnant, and, unless they have exclusively same-sex partners, must agree to use a highly effective method of contraception, and agree to continue use of this method beginning 1 month before the first administration of study drugs and for the duration of the study and for 120 days after the last injection of study drug. The participant, if adult or adolescent male, is surgically sterile, or, if capable of producing offspring, or has exclusively same-sex partners or is currently using an approved method of birth control and agrees to the continued use of this method for the duration of the study (and for 120 days after the last dose of study drug). Male participants with sex partners who are women of childbearing potential must use condoms even if surgically sterile Additional criteria apply, please contact the investigator for more information Exclusion Criteria: The participant has a current clinically significant Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnosis other than schizophrenia, including schizoaffective disorder, major depressive disorder, bipolar disorder, delirium, dementia, or amnestic or other cognitive disorders, or borderline, paranoid, histrionic, schizotypal, schizoid, or antisocial personality disorder. The participant is currently on clozapine or received electroconvulsive therapy in the last 12 months. The participant has a history of epilepsy or seizures, neuroleptic malignant syndrome, tardive dyskinesia, or other medical condition that would expose the participant to undue risk. The participant has a positive serology for human immunodeficiency virus (HIV)-1, HIV-2, hepatitis B surface antigen, and/or hepatitis C. The participant has current or history of known hypersensitivity to risperidone or any of the excipients of TV-46000 or the oral formulation of risperidone used in the stabilization phase. The participant has a substance use disorder, including alcohol and benzodiazepines but excluding nicotine and caffeine. The participant has previously participated in a Teva-sponsored clinical study with TV-46000. The participant is a pregnant or lactating female. The participant has any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (including gastrointestinal surgery). The participant has used an investigational drug within 3 months prior to screening or has participated in a non-drug clinical trial within 30 days prior to screening. Additional criteria apply, please contact the investigator for more information
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Teva Medical Expert, MD
Organizational Affiliation
Teva Branded Pharmaceutical Products R&D, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Teva Investigational Site 14769
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72211
Country
United States
Facility Name
Teva Investigational Site 14796
City
Rogers
State/Province
Arkansas
ZIP/Postal Code
72758
Country
United States
Facility Name
Teva Investigational Site 14811
City
Anaheim
State/Province
California
ZIP/Postal Code
92805
Country
United States
Facility Name
Teva Investigational Site 14794
City
Bellflower
State/Province
California
ZIP/Postal Code
90706
Country
United States
Facility Name
Teva Investigational Site 14776
City
Colton
State/Province
California
ZIP/Postal Code
92324
Country
United States
Facility Name
Teva Investigational Site 14767
City
Costa Mesa
State/Province
California
ZIP/Postal Code
92626
Country
United States
Facility Name
Teva Investigational Site 14802
City
Costa Mesa
State/Province
California
ZIP/Postal Code
92627
Country
United States
Facility Name
Teva Investigational Site 14773
City
Culver City
State/Province
California
ZIP/Postal Code
90230
Country
United States
Facility Name
Teva Investigational Site 14835
City
Garden Grove
State/Province
California
ZIP/Postal Code
92845
Country
United States
Facility Name
Teva Investigational Site 14774
City
Glendale
State/Province
California
ZIP/Postal Code
91206
Country
United States
Facility Name
Teva Investigational Site 14817
City
La Habra
State/Province
California
ZIP/Postal Code
90631
Country
United States
Facility Name
Teva Investigational Site 14771
City
Lemon Grove
State/Province
California
ZIP/Postal Code
91945
Country
United States
Facility Name
Teva Investigational Site 14823
City
Long Beach
State/Province
California
ZIP/Postal Code
90822
Country
United States
Facility Name
Teva Investigational Site 14816
City
Montclair
State/Province
California
ZIP/Postal Code
91763
Country
United States
Facility Name
Teva Investigational Site 14803
City
Norwalk
State/Province
California
ZIP/Postal Code
90650
Country
United States
Facility Name
Teva Investigational Site 14786
City
Oakland
State/Province
California
ZIP/Postal Code
94607
Country
United States
Facility Name
Teva Investigational Site 14797
City
Oceanside
State/Province
California
ZIP/Postal Code
92054
Country
United States
Facility Name
Teva Investigational Site 14827
City
Oceanside
State/Province
California
ZIP/Postal Code
92056-4515
Country
United States
Facility Name
Teva Investigational Site 14777
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Teva Investigational Site 14815
City
Pico Rivera
State/Province
California
ZIP/Postal Code
90660
Country
United States
Facility Name
Teva Investigational Site 14812
City
Riverside
State/Province
California
ZIP/Postal Code
92506
Country
United States
Facility Name
Teva Investigational Site 14785
City
San Bernardino
State/Province
California
ZIP/Postal Code
92408
Country
United States
Facility Name
Teva Investigational Site 14818
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Teva Investigational Site 14828
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Teva Investigational Site 14819
City
San Marcos
State/Province
California
ZIP/Postal Code
92078
Country
United States
Facility Name
Teva Investigational Site 14779
City
Santa Ana
State/Province
California
ZIP/Postal Code
92705
Country
United States
Facility Name
Teva Investigational Site 14788
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
Teva Investigational Site 14768
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33134
Country
United States
Facility Name
Teva Investigational Site 14783
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33134
Country
United States
Facility Name
Teva Investigational Site 14836
City
Hallandale Beach
State/Province
Florida
ZIP/Postal Code
33009
Country
United States
Facility Name
Teva Investigational Site 14787
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33016
Country
United States
Facility Name
Teva Investigational Site 14814
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33018
Country
United States
Facility Name
Teva Investigational Site 14799
City
Lauderhill
State/Province
Florida
ZIP/Postal Code
33319
Country
United States
Facility Name
Teva Investigational Site 14832
City
Miami
State/Province
Florida
ZIP/Postal Code
33126
Country
United States
Facility Name
Teva Investigational Site 14810
City
North Miami
State/Province
Florida
ZIP/Postal Code
33161
Country
United States
Facility Name
Teva Investigational Site 14831
City
Orange City
State/Province
Florida
ZIP/Postal Code
32763
Country
United States
Facility Name
Teva Investigational Site 14806
City
Orlando
State/Province
Florida
ZIP/Postal Code
32810
Country
United States
Facility Name
Teva Investigational Site 14837
City
Tampa
State/Province
Florida
ZIP/Postal Code
33614
Country
United States
Facility Name
Teva Investigational Site 14824
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30331
Country
United States
Facility Name
Teva Investigational Site 14834
City
Columbus
State/Province
Georgia
ZIP/Postal Code
31904
Country
United States
Facility Name
Teva Investigational Site 14821
City
Decatur
State/Province
Georgia
ZIP/Postal Code
30030
Country
United States
Facility Name
Teva Investigational Site 14770
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30060
Country
United States
Facility Name
Teva Investigational Site 14765
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Teva Investigational Site 14829
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60640
Country
United States
Facility Name
Teva Investigational Site 14805
City
Hoffman Estates
State/Province
Illinois
ZIP/Postal Code
60169
Country
United States
Facility Name
Teva Investigational Site 14825
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71101
Country
United States
Facility Name
Teva Investigational Site 14764
City
Glen Burnie
State/Province
Maryland
ZIP/Postal Code
21061
Country
United States
Facility Name
Teva Investigational Site 14820
City
New Bedford
State/Province
Massachusetts
ZIP/Postal Code
02740
Country
United States
Facility Name
Teva Investigational Site 14798
City
Saginaw
State/Province
Michigan
ZIP/Postal Code
48603
Country
United States
Facility Name
Teva Investigational Site 14791
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63109
Country
United States
Facility Name
Teva Investigational Site 14813
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63128
Country
United States
Facility Name
Teva Investigational Site 14826
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63132
Country
United States
Facility Name
Teva Investigational Site 14790
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Teva Investigational Site 14809
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89102
Country
United States
Facility Name
Teva Investigational Site 14792
City
Berlin
State/Province
New Jersey
ZIP/Postal Code
08009
Country
United States
Facility Name
Teva Investigational Site 14830
City
Princeton
State/Province
New Jersey
ZIP/Postal Code
08540
Country
United States
Facility Name
Teva Investigational Site 14772
City
Cedarhurst
State/Province
New York
ZIP/Postal Code
11516
Country
United States
Facility Name
Teva Investigational Site 14804
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Teva Investigational Site 14800
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Teva Investigational Site 14784
City
New York
State/Province
New York
ZIP/Postal Code
10036
Country
United States
Facility Name
Teva Investigational Site 14780
City
Staten Island
State/Province
New York
ZIP/Postal Code
10312
Country
United States
Facility Name
Teva Investigational Site 14763
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Teva Investigational Site 14782
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45417
Country
United States
Facility Name
Teva Investigational Site 14822
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73112
Country
United States
Facility Name
Teva Investigational Site 14789
City
Allentown
State/Province
Pennsylvania
ZIP/Postal Code
18104
Country
United States
Facility Name
Teva Investigational Site 14833
City
Norristown
State/Province
Pennsylvania
ZIP/Postal Code
19403
Country
United States
Facility Name
Teva Investigational Site 14775
City
Scranton
State/Province
Pennsylvania
ZIP/Postal Code
18503
Country
United States
Facility Name
Teva Investigational Site 14793
City
Thorndale
State/Province
Pennsylvania
ZIP/Postal Code
19372
Country
United States
Facility Name
Teva Investigational Site 14778
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29407
Country
United States
Facility Name
Teva Investigational Site 14781
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Facility Name
Teva Investigational Site 14766
City
Dallas
State/Province
Texas
ZIP/Postal Code
75243
Country
United States
Facility Name
Teva Investigational Site 14801
City
Houston
State/Province
Texas
ZIP/Postal Code
77081
Country
United States
Facility Name
Teva Investigational Site 14807
City
Irving
State/Province
Texas
ZIP/Postal Code
75062
Country
United States
Facility Name
Teva Investigational Site 59148
City
Bourgas
ZIP/Postal Code
8000
Country
Bulgaria
Facility Name
Teva Investigational Site 59152
City
Kazanlak
ZIP/Postal Code
6100
Country
Bulgaria
Facility Name
Teva Investigational Site 59151
City
Lovech
ZIP/Postal Code
5500
Country
Bulgaria
Facility Name
Teva Investigational Site 59149
City
Novi Iskar
ZIP/Postal Code
1282
Country
Bulgaria
Facility Name
Teva Investigational Site 59144
City
Sofia
ZIP/Postal Code
1680
Country
Bulgaria
Facility Name
Teva Investigational Site 59154
City
Varna
ZIP/Postal Code
9000
Country
Bulgaria
Facility Name
Teva Investigational Site 59150
City
Varna
ZIP/Postal Code
9020
Country
Bulgaria
Facility Name
Teva Investigational Site 59146
City
Vratsa
ZIP/Postal Code
3000
Country
Bulgaria

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the study protocol and the statistical analysis plan. Requests will be reviewed for scientific merit, product approval status, and conflicts of interest. Patient level data will be de-identified and study documents will be redacted to protect the privacy of trial participants and to protect commercially confidential information. Please email USMedInfo@tevapharm.com to make your request.)

Learn more about this trial

Study to Evaluate TV-46000 as Maintenance Treatment in Adult and Adolescent Participants With Schizophrenia

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