E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
SCHIZOPHRENIA or BIPOLAR I DISORDER |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to assess the safety and tolerability of quetiapine in children and adolescent patients with Bipolar I disorder and in adolescents with schizophrenia who are treated with doses of 400 mg/day to 800 mg/day for up to 26 weeks. The primary objective will be assessed by: - the incidence and nature of overall AEs - the rate of patient withdrawal due to AEs - the changes from the open-label baseline to Week 26 in clinical laboratory test results, vital signs, weight, BMI, ECG results, and physical examination findings. The OL baseline will be defined as the final assessment in the preceding double-blind study (D1441C00149 or D1441C00112). - the changes from OL baseline to Week 26 in the Simpson-Angus Scale total score, the Barnes Akathisia Rating Scale global score, and the Abnormal Involuntary Movement Scale total score - the proportion of patients treated with anticholinergic medication for emergent EPS |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives are as follows: 1. to evaluate the growth and development of patients receiving long-term treatment with quetiapine at doses of 400 mg/day to 800 mg/day, as assessed by change from OL baseline to Week 26 in the Tanner Stage, initiation of or changes in menses for female patients, and changes from OL baseline to Week 26 in weight and BMI 2. to evaluate the level of functioning in patients receiving long-term treatment with quetiapine at doses of 400 mg/day to 800 mg/day, as assessed by changes from OL baseline to Week 26 in the Children’s Global Assessment Scale (CGAS; Shaffer et al 1983) score |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
1. Provision of written informed consent by one or both parents or by legal guardian prior to any study procedure 2. Provision of written assent by the patient prior to any study procedure 3. Prior participation in Study D1441C00149 or Study D1441C00112 for > or = 14 days 4. Male or female; aged 13 to 17 years at randomization of Study D1441C00112 or aged 10 to 17 years at baseline of Study D1441C00149. Patients who become 18 years of age after entering Study D1441C00112 or D1441C00149 will be permitted to enter this OL study. 5. If female and of childbearing potential, must be using a reliable method of contraception. Reliable methods may include abstinence, hormonal contraceptives (eg, oral contraceptive or long-term injectable or implantable hormonal contraceptive), double-barrier methods (eg, condom and diaphragm, condom and foam, condom and sponge), intrauterine devices, and tubal ligation. 6. All female patients will need to have the absence of pregnancy confirmed by a negative serum beta hCG before OL baseline 7. DSM-IV criteria for schizophrenia or bipolar I disorder, confirmed by the K-SADS-PL at entry into the preceding double-blind Study D1441C00149 or Study D1441C00112 8. Willingness to agree not to harm self 9. Have a parent or legal guardian who will accompany the patient at each scheduled study visit, can provide reliable information, and can be responsible for receiving and dispensing study medication 10. Willingness to adhere to the schedule of assessments |
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E.4 | Principal exclusion criteria |
1. DSM-IV Axis I diagnoses of Schizophreniform Disorder, Schizoaffective Disorder, Psychotic Disorder Not Otherwise Specified (NOS), Bipolar II Disorder, Bipolar Disorder Not Otherwise Specified (NOS) 2. An interval greater than 7 days between the last double-blind study visit (OL baseline) and Day 1 3. Premorbid intelligence quotient (IQ) <70 or diagnosis of mental retardation 4. Psychosis judged to be the direct physiological consequence of a medical condition or treatment. These conditions include degenerative neurological conditions (eg, Parkinson’s disease, Huntington’s disease), cerebrovascular disease (eg, stroke), metabolic conditions (eg, vitamin B12 deficiency), autoimmune conditions (eg, systemic lupus erythematosus), viral or other infections (eg, hepatitis, mononucleosis, human immunodeficiency), and cancers. 5. Psychosis judged to be the direct physiological effect (eg, intoxication, withdrawal) of an abused medication or substance 6. History of any serious suicide attempt that required medical intervention; or current suicidal risk that cannot be safely managed as determined by the clinical judgment of the investigator 7. Serious homicidal risk or homicidal behavior within the past 3 months that resulted in adjudication 8. Known intolerance for or lack of response to quetiapine, as judged by the investigator 9. Contraindications as detailed in country-specific prescribing information for quetiapine 10. For female patients, pregnancy or lactation 11. Substance abuse or dependence including alcohol (except for caffeine or nicotine dependence), as defined in DSM-IV, within 1 month prior to screening 12. Use of depot antipsychotics, eg, haloperidol decanoate, fluphenazine decanoate or risperidone microspheres, within 1 dosing interval of the start of open-label treatment 13. Electronconvulsive therapy (ECT) within 30 days before enrollment 14. Use of potent cytochrome P450 (CYP) 3A4 inhibitors (eg, ketconazole, itraconazole, fluconazole, erythromycin, clarithromycin, troleandomycin, indinavir, nelfinavir, ritonavir, and sequinavir) in the 14 days preceding enrollment 15. Use of potent CYP 3A4 inducers (eg, phenytoin, carbamazepine, barbiturates, rifampin, glucocorticoids, Saint John’s Wort) in the 14 days preceding enrollment 16. Thyroid-stimulating hormone (TSH) concentration more than 10% above the upper limit of the normal range at OL baseline 17. Laboratory test results outside the reference range at OL baseline and considered by the investigator to be clinically significant 18. Baseline QTc interval (Fridericia formula; Puddu et al 1988) > or = 450 milliseconds at OL baseline 19. Renal, cardiovascular, hepatic, hematologic, endocrinologic, ophthalmologic, or other disease or clinical finding that is unstable or that in the opinion of the investigator would be negatively affected by study medication or that would affect study medication 20. Unstable Diabetes Mellitus (DM) with an OL baseline HgbA1c > or = 8.5 21. Patients admitted to a hospital for treatment of diabetes or diabetes related illness in past 12 weeks 22. Not under the care of a physician responsible for the patient’s DM care 23. DM clinically unstable in the opinion of the physician responsible for the patient’s diabetes management at the time of OL baseline 24. The physician responsible for the patient’s DM care has not approved the patient’s participation in the study 25. The patient has not been on the same dose of oral hypoglycemic drug(s) and/or diet for the 4 weeks prior to OL baseline. For thiazolidinediones (glitazones) this period should not be less than 8 weeks. 26. A patient taken insulin whose daily dose on one occasion in the past 4 weeks has been more than 10% above or below their mean dose in the preceding 4 weeks 27. If the patient’s CBC with WBC differential shows an ANC < 1.0 x 10 9 /L, repeat the test within 24 hours. If it remains < 1.0 x 10 9 /L, the patient will be excluded. 28. Medical condition that would affect absorption, distribution, metabolism, or excretion of study medication 29. History of seizure disorder, except febrile convulsions 30. Use of experimental drug outside of a quetiapine study within 30 days of enrollment 31. Significant medical illness which could prevent patient from completing open-label treatment 32. Previous participation in this study |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary study variables are as follows: - the incidence and nature of overall AEs from OL baseline to Week 26 - the rate of patient withdrawal due to AEs - the changes from OL baseline to Week 26 in clinical laboratory test results (eg, prolactin concentration), vital signs, weight, BMI, ECG results, and physical examination findings - the changes from OL baseline to Week 26 in the SAS, BARS, AIMS scores - the proportion of patients treated with anticholinergic medication for emergent EPS |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of the study will be defined as the date on which database lock occurs |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 7 |