E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Schizophrenia |
esquizofrenia |
|
E.1.1.1 | Medical condition in easily understood language |
Chronic, debilitating mental illness characterized by disturbances in thinking, emotional reaction, and behavior |
Enfermedad mental crónica debilitante caracterizada por alteraciones en el pensamiento, la reacción emocional y el comportamiento |
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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 | 20.0 |
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 |
|
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 long-term safety and tolerability of pimavanserin after 52 weeks of adjunctive treatment in subjects with schizophrenia |
Evaluar la seguridad y la tolerabilidad a largo plazo de la pimavanserina después de 52 semanas de tratamiento complementario en pacientes con esquizofrenia |
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E.2.2 | Secondary objectives of the trial |
Clinical global assessment of overall severity of symptoms |
Evaluación clínica global de la intensidad global de los síntomas |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Procedures: 1.Able to understand and provide signed informed consent, and must be able to sign and date a request for medical records and/or subject privacy form, if applicable, according to local regulations 2.Has a caregiver or some other identified responsible person (e.g., family member, social worker, caseworker, or nurse) considered reliable by the Investigator in providing support to the subject to help ensure compliance with study treatment, study visits, and protocol procedures and who is also able to provide input helpful for completing study rating scales 3.Is completing the Week 6 visit in Study ACP-103-034 or -039 or the Week 26 visit in Study ACP-103-038 while continuing to take his/her assigned dose of blinded study drug and may, in the Investigator’s opinion, benefit from continued adjunctive treatment with pimavanserin to an antipsychotic Medical Status: 4.If female, must be of non-childbearing potential (defined as either surgically sterilized or at least 1 year postmenopausal) or must agree to use two clinically acceptable methods of contraception (e.g., oral, intrauterine device [IUD], diaphragm plus spermicide, injectable, transdermal, or implantable contraception) •All female subjects must have a negative urine human chorionic gonadotropin (hCG) pregnancy test at Baseline and at Weeks 2, 6, 12, 20, 28, 36, 44, and 52 5.Continue to be medically stable at enrollment, in the opinion of the Investigator Medications: 6.Continues to take a stable dose of an antipsychotic within the dose range recommended according to the local Prescribing Information 7.The main antipsychotic with which the subject is being treated must continue to be one of the antipsychotics listed below: •Aripiprazole •Aripiprazole long-acting injectables –Abilify Maintena –Aristada •Asenapine •Brexpiprazole •Cariprazine •Lurasidone •Olanzapine •Risperidone •Risperidone long-acting injection |
Procedimientos: 1.Tiene que ser capaz de comprender y otorgar el consentimiento informado firmado, y tiene que ser capaz de firmar y fechar un formulario para su historia clínica y/o un formulario de confidencialidad del paciente, si procede, conforme a la normativa local 2.Tiene un cuidador u otra persona responsable identificada (p. ej., un familiar, un trabajador social, una empleada del hogar o un asistente social) que el investigador considere fiable para brindar apoyo al paciente y garantizar el cumplimiento con el tratamiento del estudio, las visitas del estudio y los procedimientos del protocolo, y que también sea capaz de aportar información útil para cumplimentar las escalas de valoración del estudio 3.Está completando la visita de la semana 6 del estudio ACP-103-034 o -039 o en la visita de la semana 26 del estudio ACP-103-038 mientras continúa tomando la dosis asignada del fármaco del estudio enmascarado y puede beneficiarse, en opinión del investigador, de continuar el tratamiento complementario con pimavanserina añadida a un antipsicótico Situación médica: 4.Si es mujer, no tiene que tener capacidad de procrear (definida como esterilizada o al menos 1 año de posmenopausia) o tiene que aceptar utilizar dos métodos anticonceptivos clínicamente aceptables (p. ej., oral, dispositivo intrauterino [DIU], diafragma más espermicida o anticonceptivo inyectable, transdérmico o implantable) •Todas las mujeres tienen que tener un resultado negativo en la prueba de embarazo de gonadotropina coriónica humana (hCG) en orina en el momento inicial y en las semanas 2, 6, 12, 20, 28, 36, 44 y 52 5.Continuar médicamente estable en la inscripción, en opinión del investigador Medicamentos: 6.Continúa tomando una dosis estable de un antipsicótico en el intervalo de dosis recomendado conforme a la información de prescripción local 7.El antipsicótico principal con el cual el paciente esté recibiendo tratamiento tiene que seguir siendo uno de los antipsicóticos indicados a continuación: •Aripiprazol •Aripiprazol inyectable de acción prolongada –Abilify Maintena –Aristada •Asenapina •Brexpiprazol •Cariprazina •Lurasidona •Olanzapina •Risperidona •Risperidona inyectable de acción prolongada |
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E.4 | Principal exclusion criteria |
Procedures: 1.Subject is judged by the Investigator or the Medical Monitor to be inappropriate for the study (e.g., significantly noncompliant in Studies ACP-103-034, -038, or -039) Medical Status: 2. A urine drug screen (UDS) result at Baseline that indicates the presence of any tested prohibited substance of potential abuse, including marijuana (even if recreational or medicinal use is legal locally) except marijuana Subjects with a result indicating the presence of marijuana are permitted if they agree to abstain from marijuana use during the study and the medical monitor approves the subject's participation 3.Is taking a medication or drug or other substance that is prohibited according to this protocol, including medications that prolong the QT interval, strong cytochrome P450 (CYP) 3A4 enzyme (CYP3A4) inhibitors and inducers 4.Known family or personal history or symptoms of long QT syndrome 5.Has a QRS interval <120 ms and QTcF > or = 460 ms OR has a QRS interval > or = 120 ms and QTcF > or = 480 ms at Baseline 6.Has developed a serious and/or unstable psychiatric, neurologic, cardiovascular, respiratory, gastrointestinal, renal, hepatic, hematologic, or other medical disorder, including cancer or malignancies that, in the judgment of the Investigator, would jeopardize the safe participation of the subject in the study 7.Is breastfeeding or lactating 8.Has a significant sensitivity or allergic reaction to pimavanserin or its excipients 9.Subject and/or caregiver has any condition that, in the opinion of the Investigator, would interfere with the ability to comply with study instructions, might confound the interpretation of the study results, or put the subject at undue risk 10.Presence of any change in medical or treatment status which may increase the risk associated with taking study medication, would interfere with safety assessments, or would confound the interpretation of the study results, based on Investigator’s judgment Neuropsychiatric: 11.Is at a significant risk of suicide, or is a danger to self or others, in the opinion of the Investigator 12.Has a significant risk of violent behavior in the opinion of the Investigator Other: 13.Is an employee of ACADIA, or has a family member who is an employee of ACADIA |
Procedimientos: 1.El investigador o el monitor médico consideran que el paciente no es idóneo para el estudio (p. ej., incumplimiento significativo en los estudios ACP-103-034, -038, o 039) Situación médica: 2.Un resultado de detección de drogas en orina (DDO) en el momento inicial que indique la presencia de cualquiera de las sustancias con potencial de abuso prohibidas analizadas, excepto la marihuana Se permite la participación de pacientes cuyo resultado indique la presencia de marihuana, si acceden a abstenerse de su consumo durante el estudio y el monitor médico aprueba su participación 3.Está tomando un medicamento o fármaco u otra sustancia que están prohibidos conforme al protocolo, incluidos medicamentos que prolongan el intervalo QT y los inhibidores e inductores potentes de la enzima 3A4 del citocromo P450 (CYP) (CYP3A4) 4.Tiene antecedentes familiares o personales o síntomas conocidos de síndrome de QT largo 5.Tiene un intervalo QRS < 120 ms y QTcF > o = 460 ms O Tiene un intervalo QRS > o = 120 ms y QTcF > o = 480 ms en el momento inicial 6.Ha desarrollado un problema médico grave y/o inestable de tipo psiquiátrico, neurológico, cardiovascular, respiratorio, gastrointestinal, renal, hepático, hematológico o de otro tipo, incluidos el cáncer o procesos malignos que, a criterio del investigador, pudieran poner en peligro la seguridad del paciente durante su participación en el estudio 7.Está dando el pecho o lactando 8.Tiene sensibilidad significativa o reacción alérgica a la pimavanserina o a sus excipientes 9.El paciente y/o el cuidador tiene cualquier afección que, en opinión del investigador, pudiera interferir con la capacidad de cumplir las instrucciones del estudio, pudiera confundir la interpretación de los resultados del estudio o que suponga un riesgo indebido para el paciente 10. Presencia de cualquier cambio en la situación médica o en el estado del tratamiento que pueda incrementar el riesgo asociado al medicamento del estudio, interferir con las evaluaciones de seguridad o confundir la interpretación de los resultados del estudio, según el criterio del investigador Neuropsiquiátrico: 11.Hay un riesgo significativo de suicidio o hay peligro de lesiones a sí mismo o a otras personas, en opinión del investigador 12.Tiene un riesgo significativo de conducta violenta, en opinión del investigador Otros: 13.Es un empleado de ACADIA o tiene un familiar que es empleado de ACADIA |
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E.5 End points |
E.5.1 | Primary end point(s) |
•Incidence and severity of adverse events (AEs), serious adverse events (SAEs), and withdrawals due to AEs •Vital sign measurements, weight, clinical laboratory assessments, physical examination findings, electrocardiogram (ECG) parameters, the Abnormal Involuntary Movement Scale (AIMS) score, the Barnes Akathisia Rating Scale (BARS) score, and the Simpson-Angus Extrapyramidal Side Effects Scale (SAS) score •Changes from Baseline in vital sign measurements, weight, clinical laboratory and ECG parameters, the AIMS score, the BARS score, and the SAS score •Suicidality: the incidence of subjects with suicidal ideation or suicidal behavior during the study as assessed by the Columbia-Suicide Severity Rating Scale (C SSRS) |
•Incidencia y seguridad de acontecimientos adversos (AA), acontecimientos adversos graves (AAG) y retiradas debidas a AA •Las mediciones de las constantes vitales, peso, evaluaciones del laboratorio clínico, los hallazgos de la exploración física, los parámetros del electrocardiograma (ECG), la escala de Movimientos involuntarios anómalos [Abnormal Involuntary Movement Scale, AIMS], la puntuación de la escala de valoración de la acatisia de Barnes (BARS) y la puntuación de la escala de Efectos secundarios extrapiramidales de Simpson-Angus (SAS) •Variaciones con respecto a los valores iniciales de las mediciones de las constantes vitales, peso, parámetros del laboratorio clínico y del ECG, puntuación AIMS, puntuación BARS y puntuación SAS •Tendencia suicida: incidencia de pacientes con ideación suicida o de conducta suicida durante el estudio evaluada mediante la escala de puntuación de la intensidad de la intención suicida de Columbia [Columbia-Suicide Severity Rating Scale, C-SSRS] |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Changes from Baseline |
Cambios desde la situación basal |
|
E.5.2 | Secondary end point(s) |
•Change from Baseline in the Clinical Global Impression – Severity scale (CGI-S) •Change from Baseline in the Clinical Global Impression of Schizophrenia Scale – Severity (CGI-SCH-S); (for subjects from Study ACP-103-038 only) |
•Variación con respecto al valor inicial de la Impresión clínica global – Escala de gravedad de la enfermedad (CGI-S) •Variación con respecto al valor inicial de la escala de impresión clínica global de la esquizofrenia – Escala de gravedad de la enfermedad (CGI-SCH-S) (solo en pacientes del estudio ACP-103-038) |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Change from Baseline |
Cambios desde la situación basal |
|
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 | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability after 52 weeks of adjunctive treatment |
Tolerabilidad tras 52 semanas de tratamiento complementario |
|
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 | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 40 |
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 |
Argentina |
Bulgaria |
Canada |
Chile |
Czech Republic |
Germany |
Hungary |
Poland |
Russian Federation |
Serbia |
Slovakia |
Spain |
Ukraine |
United States |
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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
|
LVLS |
Última visita del último paciente |
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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 | 3 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 4 |
E.8.9.2 | In all countries concerned by the trial days | 0 |