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    Clinical Trial Results:
    A Phase 3 Study to Assess the Long Term Safety, Tolerability, and Durability of Treatment Effect of ALKS 3831 in Subjects with Schizophrenia, Schizophreniform Disorder, or Bipolar I Disorder

    Summary
    EudraCT number
    2017-000918-36
    Trial protocol
    BG   AT   ES   IE   IT   RO  
    Global end of trial date
    06 Sep 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    09 Apr 2025
    First version publication date
    09 Apr 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ALK3831-A308
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03201757
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Alkermes Inc
    Sponsor organisation address
    900 Winter Street, Waltham, United States, 02451
    Public contact
    Clinical Development, Alkermes Inc, +1 7816096381, christina.arevalo@alkermes.com
    Scientific contact
    Clinical Development, Alkermes Inc, +1 7816096381, christina.arevalo@alkermes.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    06 Sep 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    06 Sep 2023
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Sep 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the long term safety, tolerability, and durability of treatment effect of ALKS 3831 in subjects with schizophrenia, schizophreniform disorder, or bipolar I disorder.
    Protection of trial subjects
    An emergency treatment card was distributed to each subject at Visit 1 and collected at the end of treatment/early termination visit. The card indicated that the subject was receiving an opioid antagonist and olanzapine and included the PI’s contact information, a suggested pain management plan and information regarding opiate blockade. Subjects were instructed to keep the card with them at all times. Study personnel confirmed that subjects had the card in their possession at each study visit. In the event of an emergency, pain management of the subject included: • Regional analgesia or use of non-opioid analgesics • If opiate anesthesia or analgesia was required, the subject was continuously monitored, in an anesthesia care setting, by persons not involved in the conduct of the surgical or diagnostic procedure. The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and the maintenance of a patent airway and assisted ventilation • Close monitoring by appropriately trained personnel in a setting equipped and staffed for cardiopulmonary resuscitation For subjects requiring emergency opioid analgesics prior to dosing, the study drug should not be administered. If opioid analgesics are required after the study drug has been dosed, it may take several days for opiate sensitivity to be restored, since samidorphan functions as a μ-opioid antagonist and could interfere with opioid-mediated pain management.
    Background therapy
    Not applicable
    Evidence for comparator
    Not applicable
    Actual start date of recruitment
    01 Jun 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 206
    Country: Number of subjects enrolled
    Russian Federation: 69
    Country: Number of subjects enrolled
    Ukraine: 118
    Country: Number of subjects enrolled
    Israel: 28
    Country: Number of subjects enrolled
    Serbia: 25
    Country: Number of subjects enrolled
    Korea, Republic of: 2
    Country: Number of subjects enrolled
    Poland: 2
    Country: Number of subjects enrolled
    United Kingdom: 2
    Country: Number of subjects enrolled
    Austria: 2
    Country: Number of subjects enrolled
    Bulgaria: 63
    Country: Number of subjects enrolled
    Ireland: 2
    Country: Number of subjects enrolled
    Italy: 4
    Worldwide total number of subjects
    523
    EEA total number of subjects
    73
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    4
    Adults (18-64 years)
    515
    From 65 to 84 years
    4
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Subjects who completed the antecedent studies (ALK3831-A304, ALK3831-A306, or ALK3831-A307) within the previous 7 days were eligible to enroll in this study.

    Period 1
    Period 1 title
    Overall Trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    This is an open label study

    Arms
    Arm title
    Treatment Period
    Arm description
    Subjects enrolled in the study were started on the same ALKS 3831 dose that they had maintained at the end of the antecedent study
    Arm type
    Experimental

    Investigational medicinal product name
    ALKS 3831
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    olanzapine / samidorphan once daily oral dosing Strengths: 5mg/10mg, 10mg/10mg, 15mg/10mg, 20mg/10mg

    Number of subjects in period 1
    Treatment Period
    Started
    523
    Completed
    188
    Not completed
    335
         Consent withdrawn by subject
    133
         Study terminated by Sponsor
    1
         Not yet determined
    5
         Adverse event, non-fatal
    44
         Other
    92
         Pregnancy
    2
         Lost to follow-up
    37
         Protocol deviation
    20
         Lack of efficacy
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Trial
    Reporting group description
    Safety population

    Reporting group values
    Overall Trial Total
    Number of subjects
    523 523
    Age categorical
    Units: Subjects
        Adolescents (12-17 years)
    4 4
        Adults (18-64 years)
    519 519
    Gender categorical
    Units: Subjects
        Female
    201 201
        Male
    322 322
    Ethnicity
    Units: Subjects
        Not Hispanic or Latino
    504 504
        Hispanic or Latino
    19 19
    Race
    Units: Subjects
        White
    380 380
        Black or African American
    126 126
        Asian
    8 8
        American Indian or Alaska Native
    1 1
        Native Hawaiian or Other Pacific Islander
    0 0
        Other
    1 1
        Muluiple Races
    7 7
    Height
    Units: cm
        median (full range (min-max))
    172.70 (145.0 to 201.1) -
    Weight
    Units: kg
        median (full range (min-max))
    75.25 (43.2 to 137.8) -
    Body Mass Index
    Units: kg/m^2
        median (full range (min-max))
    25.30 (15.7 to 43.3) -
    CGI-S
    Units: units on a scale
        median (full range (min-max))
    3.00 (1.0 to 6.0) -

    End points

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    End points reporting groups
    Reporting group title
    Treatment Period
    Reporting group description
    Subjects enrolled in the study were started on the same ALKS 3831 dose that they had maintained at the end of the antecedent study

    Primary: Change from baseline in Clinical Global Impressions-Severity (CGI-S) score by visit

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    End point title
    Change from baseline in Clinical Global Impressions-Severity (CGI-S) score by visit [1]
    End point description
    End point type
    Primary
    End point timeframe
    Up to 48 months
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The statistical analysis performed here was only summary statistics which consists of N, mean, STD, min, and max’
    End point values
    Treatment Period
    Number of subjects analysed
    523
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Change from baseline
    -0.24 ( 0.651 )
    No statistical analyses for this end point

    Primary: Change from baseline in IWQOL-Lite scores by visit

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    End point title
    Change from baseline in IWQOL-Lite scores by visit [2]
    End point description
    End point type
    Primary
    End point timeframe
    Up to 48 months
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The statistical analysis performed here was only summary statistics which consists of N, mean, STD, min, and max’
    End point values
    Treatment Period
    Number of subjects analysed
    110
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Last schedule on treatment visit
    -1.3 ( 11.97 )
    No statistical analyses for this end point

    Other pre-specified: Time to treatment discontinuation

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    End point title
    Time to treatment discontinuation
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 48 months
    End point values
    Treatment Period
    Number of subjects analysed
    523
    Units: Days
    588
    No statistical analyses for this end point

    Other pre-specified: Shift analysis in Clinical Global Impressions-Severity (CGI-S) score

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    End point title
    Shift analysis in Clinical Global Impressions-Severity (CGI-S) score
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 48 months
    End point values
    Treatment Period
    Number of subjects analysed
    109
    Units: Units on a scale
    number (not applicable)
        Markedly to Extremely ill >=5
    3
        Moderately ill (4)
    27
        Normal to Mildly ill =< 3
    79
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs were monitored continuously from the time a subject signed the informed consent document until completion of the final study visit (Visit 49). Safety follow-up visit no later than Visit 50.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.0
    Reporting groups
    Reporting group title
    Safety population
    Reporting group description
    -

    Serious adverse events
    Safety population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    35 / 523 (6.69%)
         number of deaths (all causes)
    1
         number of deaths resulting from adverse events
    0
    Investigations
    Blood urine present
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Infected naevus
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate cancer
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Concussion
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Craniocerebral injury
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femur fracture
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skull fractured base
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic haemothorax
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic intracranial haemorrhage
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic liver injury
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vena cava injury
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Aortic valve incompetence
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pericardial haemorrhage
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Drug withdrawal convulsions
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intracranial aneurysm
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Cholecystitis
         subjects affected / exposed
    2 / 523 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Anaphylactoid shock
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Crohn's disease
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematochezia
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mallory-Weiss syndrome
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Obstructive pancreatitis
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    2 / 523 (0.38%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Schizophrenia
         subjects affected / exposed
    11 / 523 (2.10%)
         occurrences causally related to treatment / all
    0 / 11
         deaths causally related to treatment / all
    0 / 0
    Psychotic disorder
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Aggression
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute psychosis
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Completed suicide
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Depression suicidal
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mania
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric symptom
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychotic symptom
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Substance-induced psychotic disorder
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Suicide attempt
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Large intestine infection
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 523 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    Safety population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    279 / 523 (53.35%)
    Investigations
    Weight increased
         subjects affected / exposed
    51 / 523 (9.75%)
         occurrences all number
    51
    Weight decreased
         subjects affected / exposed
    30 / 523 (5.74%)
         occurrences all number
    30
    Blood creatine phosphokinase increased
         subjects affected / exposed
    22 / 523 (4.21%)
         occurrences all number
    22
    Blood triglycerides increased
         subjects affected / exposed
    14 / 523 (2.68%)
         occurrences all number
    14
    Low density lipoprotein increased
         subjects affected / exposed
    13 / 523 (2.49%)
         occurrences all number
    13
    Alanine aminotransferase increased
         subjects affected / exposed
    12 / 523 (2.29%)
         occurrences all number
    12
    Blood prolactin increased
         subjects affected / exposed
    12 / 523 (2.29%)
         occurrences all number
    12
    Nervous system disorders
    Headache
         subjects affected / exposed
    37 / 523 (7.07%)
         occurrences all number
    37
    Somnolence
         subjects affected / exposed
    31 / 523 (5.93%)
         occurrences all number
    31
    Dizziness
         subjects affected / exposed
    12 / 523 (2.29%)
         occurrences all number
    12
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    30 / 523 (5.74%)
         occurrences all number
    30
    Vomiting
         subjects affected / exposed
    15 / 523 (2.87%)
         occurrences all number
    15
    Constipation
         subjects affected / exposed
    13 / 523 (2.49%)
         occurrences all number
    13
    Diarrhoea
         subjects affected / exposed
    11 / 523 (2.10%)
         occurrences all number
    11
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    32 / 523 (6.12%)
         occurrences all number
    32
    Insomnia
         subjects affected / exposed
    31 / 523 (5.93%)
         occurrences all number
    31
    Schizophrenia
         subjects affected / exposed
    15 / 523 (2.87%)
         occurrences all number
    15
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    11 / 523 (2.10%)
         occurrences all number
    11
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    17 / 523 (3.25%)
         occurrences all number
    17
    Upper respiratory tract infection
         subjects affected / exposed
    13 / 523 (2.49%)
         occurrences all number
    13

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Sep 2017
    Amendment 1: Added urine pregnancy test for all women at monthly intervals. Provided clear guidance regarding hospitalizations in special circumstances would be assessed for safety. Updated the list of CYP3A inhibitors and inducers. Further described medications that exhibit drug interactions potential with olanzapine, including detail on inhibitors and inducers of CYP1A2 and medicinal products known to increase QTc interval. Specified that subjects must have met the eligibility criteria of one of the antecedent studies (ALK3831-A304, ALK3831-A306, ALK3831-A307) at the time of enrollment of the antecedent study, to qualify for participation in study ALK3831-A308.
    10 Jan 2018
    Inclusion of a new Benefit-Risk Assessment section at the request of regulatory authorities. Language regarding contraception requirements was updated. Eligibility review was updated
    09 May 2019
    The study was anticipated to end by the fourth quarter of 2022. The change in the duration of the study allowed treatment with study drug for 24 to 48 months, or until regulatory action; duration varied by subject. Addition of language to indicate that per local requirements, if a partner of a male subject became pregnant, she could be required to sign an informed consent form to obtain pregnancy follow-up information. Specification that transition from schizophreniform to schizophrenia was not considered an AE unless deemed so by the Investigator.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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