E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Schizophrenia |
Esquizofrenia |
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E.1.1.1 | Medical condition in easily understood language |
Schizophrenia |
Esquizofrenia |
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E.1.1.2 | Therapeutic area | Psychiatry and Psychology [F] - Mental Disorders [F03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10039626 |
E.1.2 | Term | Schizophrenia |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
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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 |
To evaluate the treatment effect of AMG 747 compared to placebo on negative symptoms as measured by the Negative Symptom Assessment Scale (NSA-16) in patients with schizophrenia stabilized with ongoing antipsychotic therapy |
Evaluar el efecto del tratamiento con AMG 747 en comparación con placebo sobre los síntomas negativos evaluados mediante la escala de evaluación de síntomas negativos (NSA-16) en pacientes con esquizofrenia estabilizada en tratamiento con antipsicóticos. |
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E.2.2 | Secondary objectives of the trial |
- To evaluate the effect of AMG 747 on the proportion of subjects achieving clinically meaningful improvement from baseline, as defined by a => 20% decrease from baseline on negative symptoms as measured by the NSA-16; - To evaluate the effect of AMG 747 on symptoms of schizophrenia as measured by the PANSS total score and Marder factor scores; - To evaluate the effect of AMG 747 on global change as measured by the CGI-S and CGI-I scales; - To evaluate the effect of AMG 747 on cognitive function as measured by the MATRICS Consensus Cognitive Battery (MCCB); - To evaluate the effect of AMG 747 on everyday functioning as measured by the PSP scale; - To evaluate the effect of AMG 747 on PROs as measured by the Q-LES-Q-18 and SDS; - To evaluate safety and tolerability of AMG 747. |
Evaluar el efecto de AMG 747: Sobre la proporción de sujetos que consiguen una mejoría clínicamente significativa en comparación con el nivel basal, definida como una disminución => 20% desde el nivel basal de los síntomas negativos, mediante la NSA-16.Sobre los síntomas de la esquizofrenia, mediante la puntuación total de la escala de los síndromes positivo y negativo (PANSS) y las puntuaciones de los factores de Marder.Sobre el cambio global, mediante las escalas de impresión clínica global de gravedad (CGI-S) y de impresión clínica global de mejoría (CGI-I).Sobre la función cognitiva, mediante la batería cognitiva de consenso MATRICS (MCCB).Sobre el desempeño cotidiano, mediante la escala de funcionamiento personal y social (PSP).Sobre los resultados notificados por los pacientes (PRO), mediante el cuestionario sobre calidad de vida: satisfacción y placer (Q-LES-Q-18) y la escala de discapacidad de Sheehan (SDS).La seguridad y la tolerabilidad de AMG 747. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
- Pharmacokinetic (PK) sub-study, 21 October 2011: This sub-study will be carried out on a subset of approximately 90 subjects (approximately 20 subjects per AMG 747 treatment group) at selected sites. These subjects will be required to sign an additional optional informed consent to participate in this sub-study. The PK sub-study enrollment will be blinded; however, the PK samples will be analyzed only for those subjects assigned to an AMG 747 treatment group. PK sub-study enrollment will close once the target number of PK sub-study participants has been reached. PK sub-study subjects will have additional blood samples collected at 1.5, 4 and 24 hours post-dose at baseline/day 1 (ie, after first IMP dose) and at 0.5 and 2 hours post-dose at week 4. The purpose of this sub-study is to evaluate the pharmacokinetic profile of AMG 747 when given as a daily oral dose in subjects with schizophrenia stabilized with ongoing antipsychotic therapy.
- Pharmacogenetic sub-study, 21 October 2011: If a subject signs the additional optional informed consent (Pharmacogenetic Consent), DNA extracted from the cell pellets from pre-dose PK plasma samples on baseline/day 1, week 4 and week 8 may be analyzed for optional, exploratory pharmacogenetic analyses. These optional analyses focus on inherited genetic variations, to evaluate their possible correlation to the disease and/or responsiveness to the therapies used in this study. The goals of these optional studies include the use of genetic markers to help in the investigation of neuropsychiatric disorders such as schizophrenia and/or to identify subjects who may respond positively or negatively to AMG 747. |
- Subestudio farmacocinético (PK), 21 Octubre 2011: Se llevará a cabo en un subgrupo de 90 sujetos de algunos centros. La participación será opcional y los sujetos que accedan deberán firmar un consentimiento informado específico. Se tomarán muestras 1.5, 4 y 24 h post-dosis en la visita basal y a las 0.5 y 2 horas post-dosis en la semana 4 para evaluar el perfil PK de AMG 747. - Subestudio farmacogenético, 21 October 2011: Para participar en este subestudio opcional, los pacientes deberán firmar un consentimiento informado específico. Se analizará el DNA del sedimento celular de las muestras de plasma extraídas en las visitas basal y semanas 4 y 8. Los análisis se centrarán en las variaciones genéticas hereditarias para valorar su posible correlación con la enfermedad y la respuesta al tratamiento del estudio. El propósito del subestudio incluye la utilización de marcadores genéticos que ayuden en la investigación de la patología y en la identificación de sujetos que puedan responder positivamente a AMG 747. |
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E.3 | Principal inclusion criteria |
- Adults, 18-60 years of age upon entry into screening; - Diagnosis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) schizophrenia; - Total score on the PANSS Marder Negative Symptom Factor Scale (NSFS) => 20, Total score on the PANSS Marder Positive Symptom Factor Scale (PSFS) ? 30; - Receiving stable antipsychotic therapy for at least 8 weeks prior to screening; - Receiving a stable dose of other psychotropic agents for at least 8 weeks prior to screening; - Subject has had a stable residence or living arrangement for at least 8 weeks prior to screening and the residence or living arrangement is not anticipated to change for the duration of the study; - Subject or subject's legally acceptable representative has provided informed consent. |
-Adultos de 18 a 60 años de edad en el momento de la selección. -Diagnóstico de esquizofrenia del Manual diagnóstico y estadístico de los trastornos mentales, cuarta edición, revisión del texto (DSM-IV-TR). - Puntuación total de la escala de factores de síntomas negativos de Marder (NSFS) de la PANSS => 20, con una puntuación de => 4 en el menos 2 de los siguientes elementos de la PANSS: N1, N2, N3, N4 y N6; - puntuación total en la escala de factores de síntomas positivos de Marder (PSFS) de la PANSS <= 30, con una puntuación de <= 4 en cada elemento de la PSFS, excepto por una puntuación de 5 en no más de 1 elemento; y -puntuación del elemento P2 de la PANSS <= 4. -Recibir tratamiento antipsicótico estable (para este estudio, estabilidad se define como sin nueva medicación, sin aumento y con una disminución <= 25% en cualquier dosis del antipsicótico) durante al menos 8 semanas antes de la selección. -Recibir una dosis estable de otros agentes psicotrópicos (definida como una disminución <= 25% de la dosis del psicotrópico) durante al menos 8 semanas antes de la selección -El sujeto ha tenido una residencia o un domicilio estable durante al menos 8 semanas antes de la selección y no está previsto que la residencia o el domicilio cambien mientras dure el estudio. -El sujeto o su representante legal autorizado ha proporcionado el consentimiento informado. |
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E.4 | Principal exclusion criteria |
- Current schizoaffective or bipolar disorder, panic disorder, obsessive compulsive disorder, evidence of mental retardation by history or clinical examination or known premorbid IQ ? 70; - Clinically significant suicidal ideation or suicide attempts, assaultive behavior or marked changes in mood within the 8 weeks prior to screening, or currently endorsing suicidal ideation in clinical exam; - Substance abuse (with the exception of nicotine or caffeine abuse) within the 8 weeks prior to screening, or during screening; - Substance dependence (with the exception of nicotine or caffeine dependence) within the 6 months prior to screening or during screening; - Planning to initiate a smoking cessation therapy or otherwise substantially modify nicotine use during the study; - Positive urine drug test for substances of abuse (with the exception of positive screens for prescribed agents such as benzodiazepines). |
Trastorno bipolar o esquizoafectivo en curso, trastorno de pánico, trastorno obsesivo-compulsivo, evidencia de retraso mental según la historia clínica o la exploración clínica o CI premórbido conocido <=70. Pensamientos suicidas clínicamente significativos o intentos de suicidio, comportamiento agresivo o cambios marcados de humor en las 8 semanas previas a la selección, o confirmación actual de pensamientos suicidas durante la exploración clínica Abuso de sustancias (excepto el abuso de nicotina o cafeína) en las 8 semanas previas a la selección, o durante la selección. Dependencia de sustancias (excepto la dependencia de nicotina o cafeína) en los 6 meses previos a la selección, o durante la selección. Tener previsto empezar un tratamiento para dejar de fumar o modificar de forma sustancial el uso de la nicotina durante el estudio. Prueba positiva de sustancias de abuso en la orina (a excepción de resultados positivos para agentes prescritos, como las benzodiacepinas). Para el resto de criterios de exclusión ver el protocolo |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from baseline to week 12 in negative symptoms, as measured by the NSA-16 total score |
Cambio en los síntomas negativos, evaluados mediante la puntuación total de la NSA-16, desde el nivel basal hasta la semana 12. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
- Response defined as a => 20% decrease in the NSA-16 total score at week 12; - Change from baseline to week 12 on the PANSS total score and Marder factor scores (positive, negative, disorganized thought, hostility/excitement, anxiety/depression symptoms); - Change from baseline to week 12 on the CGI-S; - CGI-I scores at week 12; - Change from baseline to week 12 on the MCCB; - Change from baseline to week 12 on the PSP; - Change from baseline to week 12 on the Q-LES-Q-18 and SDS; Safety Endpoints: - Adverse events; - Clinical laboratory values and vital signs; - 12-lead ECG; - Calgary Depression Scale for Schizophrenia (CDSS), Columbia-Suicide Severity Rating Scale (C-SSRS), Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), and Simpson-Angus Scale (SAS). |
-Respuesta definida como una disminución => 20% en la puntuación total de la NSA-16 en la semana 12. Cambio en la puntuación total de la PANSS y en las puntuaciones de los factores de Marder (síntomas positivos, negativos, de pensamiento desorganizado, de hostilidad/nerviosismo o de ansiedad/depresión) desde el nivel basal hasta la semana 12. Cambio en la CGI-S desde el nivel basal hasta la semana 12. Puntuaciones de la CGI-I en la semana 12. Cambio desde el nivel basal hasta la semana 12 en la MCCB. Cambio en la PSP desde el nivel basal hasta la semana 12. Cambio en el Q-LES-Q-18 y la SDS desde el nivel basal hasta la semana 12. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
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) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 10 |
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 | No |
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 |
European Union |
Australia |
Canada |
New Zealand |
Singapore |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
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 time when the last subject completes the last study visit |
El momento en el que el último sujeto completa la última visita del estudio |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 11 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 11 |
E.8.9.2 | In all countries concerned by the trial days | 0 |