Intramuscular Depot Formulation of Aripiprazole as Maintenance Treatment in Patients With Schizophrenia (ASPIRE)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Otsuka Pharmaceutical Development & Commercialization, Inc.
ClinicalTrials.gov Identifier:
NCT00706654
First received: June 25, 2008
Last updated: June 14, 2012
Last verified: June 2012
  Purpose

The purpose of the this trial is to evaluate the efficacy, safety, and tolerability of an intramuscular (IM) depot formulation of aripiprazole as maintenance treatment in patients with schizophrenia

The trial is designed into three treatment phases. Phase 1 is designed to allow for a subject to be converted from the current antipsychotic treatment to oral non-generic aripiprazole monotherapy (oral conversion phase from 4 to 6 weeks). During Phase 2 the subject will be stabilized on oral non-generic aripiprazole monotherapy. Once the subject is stabilized in Phase 2 (oral stabilization phase from minimum 8 weeks to maximum 28 weeks), they are eligible to be randomized into the double-blind IM depot maintenance phase, Phase 3. During Phase 3, the subject will be assessed for exacerbation of psychotic symptoms and impending relapse for up to 38 weeks.


Condition Intervention Phase
Schizophrenia
Drug: Intramuscular (IM) Depot Aripiprazole Formulation
Drug: Oral Aripiprazole 10 mg - 30 mg, daily
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: A 38-week, Multicenter, Randomized, Double-blind, Active-controlled Study to Evaluate the Efficacy, Safety, and Tolerability of an Intramuscular Depot Formulation of Aripiprazole as Maintenance Treatment in Patients With Schizophrenia

Resource links provided by NLM:


Further study details as provided by Otsuka Pharmaceutical Development & Commercialization, Inc.:

Primary Outcome Measures:
  • Proportion of subjects experiencing exacerbation of psychotic symptoms/impending relapse by end of 26 weeks from Phase 3 randomization, in schizophrenic patients who maintained stability on oral aripiprazole for at least 8 weeks in Phase 2 of the study [ Time Frame: 26 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time to exacerbation of psychotic symptoms/impending relapse from date of randomization in Phase 3 [ Time Frame: 38 weeks ] [ Designated as safety issue: No ]
  • Percentage of responders at endpoint in Phase 3 [ Time Frame: 38 weeks ] [ Designated as safety issue: No ]
  • Percentage of subjects achieving remission [ Time Frame: 38 weeks ] [ Designated as safety issue: No ]

Enrollment: 1148
Study Start Date: September 2008
Study Completion Date: March 2012
Primary Completion Date: March 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
Intramuscular (IM) Depot Aripiprazole Formulation
Drug: Intramuscular (IM) Depot Aripiprazole Formulation
Intramuscular (IM) Depot Aripiprazole Formulation 400 mg or 300 mg, once a month injection
Active Comparator: 2
Active Comparator: Oral Aripiprazole
Drug: Oral Aripiprazole 10 mg - 30 mg, daily
Oral Aripiprazole 10 mg - 30 mg, daily
Active Comparator: 3
Active Comparator: Treatment of Aripiprazole IM Depot
Drug: Intramuscular (IM) Depot Aripiprazole Formulation
Intramuscular (IM) Depot Aripiprazole Formulation 50 mg or 25 mg, once a month injection

Detailed Description:

This will be a randomized, double-blind, active-controlled study consisting of a screening phase and three treatment phases. Eligibility will be determined during a screening phase of 2 to 42 days. Subjects currently receiving oral treatment with an antipsychotic other than non-generic aripiprazole will enter Phase 1, and subjects with a lapse in aripiprazole or other antipsychotic treatment at the time of study entry ("lapse" defined as >3 consecutive days without medication) will enter directly into Phase 2.

During Phase 1 (oral conversion), subjects will be cross-titrated during weekly visits from other antipsychotics to oral non-generic aripiprazole monotherapy over a minimum of 4 weeks and a maximum of 6 weeks. During Phase 2 (that will be a minimum of 8 weeks and a maximum of 28 weeks in duration), subjects will be assessed bi-weekly and stabilized on an oral dose of aripiprazole ranging from 10 mg to 30 mg daily. After stability criteria are met at Phase 2, subjects are eligible to be randomized into the double-blind IM depot maintenance phase, Phase 3. Subjects will be randomized with a 2:2:1 (aripiprazole IM depot 400 mg, oral aripiprazole, aripiprazole IM depot 50 mg). During Phase 3 subjects will be assessed for impending relapse/exacerbation of psychotic symptoms. If a subject is identified with impending relapse/exacerbation of psychotic symptoms, they will be withdrawn from the trial and given the opportunity to enroll into an open-label aripiprazole IM depot trial, 31-08-248. Alternatively, subjects that complete Phase 3 (up to and including week-38) will have the option to enroll into an open-label aripiprazole IM depot trial, 31-08-248. Alternatively, subjects that complete Phase 3 (up to and including week-38) will have the option to enroll into an open-label aripiprazole IM depot trial, 31-08-248.

The enrollment figure includes re-screened patients.

  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subjects who are able to provide written informed consent and/or consent obtained from a legally acceptable representative (as require by IRB/IEC), prior to the initiation of any protocol-required procedures.
  • Male and female subjects 18 to 60 years of age, inclusive, at time of informed consent.
  • Subjects with a current diagnosis of schizophrenia as defined by DSM-IV-TR criteria and a history of the illness for at least three years prior to screening.
  • Subjects who, in the investigator's judgment, require chronic treatment with an antipsychotic medication.
  • Subjects able to understand the nature of the study and follow protocol requirements, including the prescribed dosage regimens, tablet ingestion, IM depot injection, discontinuation of prohibited concomitant medications, who can read and understand the written word in order to complete patient-reported outcomes measures, and who can be reliably rated on assessment scales.

Exclusion Criteria:

  • Subjects with a current DSM-IV-TR diagnosis other than schizophrenia, including schizoaffective disorder, major depressive disorder, bipolar disorder, delirium, dementia, amnestic or other cognitive disorders. Also, subjects with borderline, paranoid, histrionic, schizotypal, schizoid, or antisocial personality disorder.
  • Subjects with schizophrenia that are considered resistant/refractory to antipsychotic treatment by history or response only to clozapine.
  • Subjects with a significant risk of violent behavior or a significant risk of committing suicide based on history or investigator's judgment.
  • Subjects who currently meet DSM-IV-TR criteria for substance dependence; including alcohol and benzodiazepines, but excluding caffeine and nicotine, or two positive drug screens for cocaine.
  • Subjects who are known to be allergic, intolerant, or unresponsive to prior treatment with aripiprazole or other quinolinones, or hypersensitivity to antipsychotic agents, including aripiprazole..
  • Subjects with a history of neuroleptic malignant syndrome or clinically significant tardive dyskinesia at screening.
  • Subjects with uncontrolled thyroid function abnormalities.
  • Subjects with a history of seizures, neuroleptic malignant syndrome, clinically significant tardive dyskinesia, or other medical condition that would expose the subject to undue risk or interfere with study assessments.
  • Subjects who are involuntary incarcerated.
  • Subjects who have undergone electroconvulsive therapy within 180 days of entry into Phase 2.
  • Subjects who have used an investigational agent within 30 days of screening; and prior participation in a clinical study with aripiprazole IM depot.
  • Subjects with clinically significant abnormalities in laboratory test results, vital signs, or ECG results.
  • Subjects hospitalized for more than 30 days in the 90 days prior to Phase 1 (or Phase 2 for subjects bypassing Phase 1).
  • Subjects requiring more than one benzodiazepine beyond screening (eg, lorazepam and oxazepam).
  • Subjects who fail to wash-out from prohibited concomitant medications, including the use of CYP2D6 or CYP3A4 inhibitors or CYP3A4 inducers, antipsychotics, antidepressants (including MAOIs), and mood stabilizers, during screening and Phase 1.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00706654

  Show 98 Study Locations
Sponsors and Collaborators
Otsuka Pharmaceutical Development & Commercialization, Inc.
  More Information

No publications provided

Responsible Party: Otsuka Pharmaceutical Development & Commercialization, Inc.
ClinicalTrials.gov Identifier: NCT00706654     History of Changes
Other Study ID Numbers: 31-07-247
Study First Received: June 25, 2008
Last Updated: June 14, 2012
Health Authority: United States: Food and Drug Administration
Austria: Federal Office for Safety in Health Care
Belgium: Federal Agency for Medicinal Products and Health Products
Bulgaria: Ministry of Health
Chile: Instituto de Salud Publica de Chile
Croatia: Ministry of Health and Social Care
Estonia: The State Agency of Medicine
France: Ministry of Health
Hungary: National Institute of Pharmacy
Italy: Ministry of Health
Poland: Ministry of Health
South Africa: Medicines Control Council
South Korea: Korea Food and Drug Administration (KFDA)
Thailand: Food and Drug Administration

Keywords provided by Otsuka Pharmaceutical Development & Commercialization, Inc.:
Aripiprazole
Intramuscular (IM) Depot
Schizophrenia

Additional relevant MeSH terms:
Schizophrenia
Schizophrenia and Disorders with Psychotic Features
Mental Disorders
Aripiprazole
Antipsychotic Agents
Tranquilizing Agents
Central Nervous System Depressants
Physiological Effects of Drugs
Pharmacologic Actions
Central Nervous System Agents
Therapeutic Uses
Psychotropic Drugs

ClinicalTrials.gov processed this record on May 22, 2013