E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
|
E.1.1.1 | Medical condition in easily understood language |
Schizophrenia is a psychotic disorder (or group of disorders) marked by severely impaired thinking, emotions, and behaviours. |
|
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 | 19.0 |
E.1.2 | Level | HLGT |
E.1.2 | Classification code | 10039628 |
E.1.2 | Term | Schizophrenia and other psychotic disorders |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
|
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 efficacy of flexibly dosed SEP-363856 (50 or 75 mg/day) compared with placebo in acutely psychotic adult subjects with schizophrenia as measured by the Positive and Negative Syndrome Scale (PANSS). |
|
E.2.2 | Secondary objectives of the trial |
To evaluate the efficacy of flexibly-dosed SEP-363856 (50 or 75 mg/day) compared with placebo in acutely psychotic adult subjects with schizophrenia. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
To qualify for participation, subjects must meet all of the following inclusion criteria:
Inclusion criteria (not all inclusive):
To qualify for participation, subjects must meet all of the following inclusion criteria:
1.Male or female subject between 18 to 40 years of age (inclusive) at the time of consent.
2.Subject meets DSM_5 criteria for a primary diagnosis of schizophrenia as established by clinical interview (using the DSM_5 as a reference and confirmed using the SCID_CT). The duration of the subject's illness whether treated or untreated must be ≥ 6 months.
3.Subject must have a CGI_S score ≥ 4 (moderate or greater) at screening and Baseline.
4.Subject must have a PANSS total score ≥ 80 and a PANSS subscale score ≥ 4 (moderate) on 2 or more of the following PANSS subscale items: delusions, conceptual disorganization, hallucinations, and unusual thought content at screening and Baseline.
5.Subject has an acute exacerbation of psychotic symptoms (no longer than 2 months) and marked deterioration of function from Baseline (by history) AND subject has been hospitalized for the purpose of treating an acute psychotic exacerbation for 2 consecutive weeks or less immediately before screening.
Subjects who have been hospitalized for more than 2 weeks for reasons unrelated to acute exacerbation can be included with concurrence from the Medical Monitor that such hospitalization was other than acute relapse. For example, subjects in a long-term hospital setting who have an acute exacerbation and are transferred to an acute unit are eligible for the study.
6.Subject has had no more than 2 prior hospitalizations for treatment of acute exacerbation of schizophrenia (not including the current hospitalization).
7.At Baseline, subject must have a total score < 5 on the SAS.
Randomization Criteria
To qualify for randomization, subjects must meet all of the following randomization criteria:
1.Subject must have a PANSS total score ≥ 80 at Baseline (Day 1).
2.Subject must have a PANSS subscale score ≥ 4 on 2 or more of the following PANSS subscale items: delusions, conceptual disorganization, hallucinations, and unusual thought content at Baseline (Day 1).
3.Subject must have a CGI_S score ≥ 4 at Baseline (Day 1).
4.Subject must have a total score < 5 on the SAS at Baseline (Day 1).
5.Subject must not answer “yes” to “Suicidal Ideation” Item 4 (active suicidal ideation with some intent to act, without specific plan) or Item 5 (active suicidal ideation with specific plan and intent) on the C_SSRS assessment at Baseline (ie, since last visit).
Subject must meet all other inclusion and none of the exclusion criteria at Baseline (Day 1). |
|
E.4 | Principal exclusion criteria |
Exclusion Criteria (not all inclusive):
To qualify for participation, subjects must not meet any of the following exclusion criteria:
1.Subject answers “yes” to “Suicidal Ideation” Item 4 (active suicidal ideation with some intent to act, without specific plan) or Item 5 (active suicidal ideation with specific plan and intent) on the C_SSRS assessment at Screening (ie, in the past one month) and at Baseline (ie, since last visit).
2.Subject has previously received SEP_363856.
3.Subject has a lifelong history or presence of symptoms consistent with a major psychiatric disorder other than primary schizophrenia as defined by DSM-V unless symptoms were rediagnosed as consistent with primary schizophrenia. Exclusionary disorders include but are not limited to alcohol use disorder (within past 12 months), substance (other than nicotine or caffeine) use disorder within past 12 months, major depressive disorder, bipolar depression, mania, schizoaffective disorder, obsessive compulsive disorder, posttraumatic stress disorder. Previous or current symptoms of mild to moderate mood dysphoria or anxiety are allowed so long as these symptoms have not been a focus of primary treatment.
4.Subject is at significant risk of harming him/herself or others according to the Investigator's judgment.
5.Subject has attempted suicide within 3 months prior to screening
6.Subject is involuntarily hospitalized.
7.Subject is receiving a total dose of antipsychotic medication equivalent to > 12.0mg/day of haloperidol at Screening.
8.Subject has received electroconvulsive therapy treatment within the 6 months prior to screening or is expected to require ECT during the study.
9.Subject has had past episodes of significant extrapyramidal symptoms (EPS) under current medication that required dose modification or the addition of anti-Parkinson's treatment within the last 6 months.
10.Subject is considered resistant to antipsychotic treatment by the Investigator, defined as failure to respond to 2 or more marketed antipsychotic agents, given at adequate dose for at least 4 weeks (28 days) within 1 year (365 days) before Screening (eg, the subject was hospitalized because of worsening psychotic symptoms due to insufficient clinical response or required frequent use of other antipsychotic drugs on a temporary basis).
11.Subject has a history of treatment with clozapine for refractory psychosis and/or subject has been treated with clozapine (for any reason) within 4 months of Screening.
12.Subject is currently participating, or has participated in, a study with an investigational or marketed compound or device within 6 months prior to signing the informed consent, or has participated in 2 or more studies within 24 months prior to signing the informed consent |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Change from Baseline in PANSS total score at Week 4 |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
• Change from Baseline in CGI-S score at Week 4.
• Change from Baseline in PANSS subscale scores at Week 4.
• Change from Baseline in BNSS total score at Week 4
• Change from Baseline in MADRS total score at Week 4.
• Proportion of subjects who achieve a response, defined as a 20% or greater improvement from Baseline in PANSS total score at Week 4.
• The incidence of overall AEs, serious AEs (SAEs) and AEs (or SAEs) leading to discontinuation.
• Absolute values and changes from Baseline in clinical laboratory tests (hematology, serum chemistry, urinalysis), and clinical evaluations (vital signs, body weight, BMI, blood pressure [supine and standing], heart rate [supine and standing], 12-lead ECGs).
• Frequency of subjects with suicidal ideation or suicidal behavior using the C-SSRS. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
For CGI-S score, PANSS subscale score, BNSS total score, MADRS total score time point of evaluation is 4 weeks. AEs will be evaluated every week. |
|
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 | Yes |
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 | Yes |
E.6.11 | Pharmacogenomic | Yes |
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 | 2 |
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 | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 13 |
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 |
Hungary |
Romania |
Russian Federation |
Serbia |
Ukraine |
United States |
|
E.8.7 | Trial has a data monitoring committee | Yes |
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
|
|
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 | 1 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 1 |
E.8.9.2 | In all countries concerned by the trial days | 0 |