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An Evaluation Of BW430C (Lamotrigine) Versus Placebo In The Prevention Of Mood Episodes In Bipolar I Disorder Patients
This study has been completed.
First Received: October 26, 2007   Last Updated: November 12, 2009   History of Changes
Sponsor: GlaxoSmithKline
Information provided by: GlaxoSmithKline
ClinicalTrials.gov Identifier: NCT00550407
  Purpose

This study is planned to objectively assess the efficacy and safety of lamotrigine maintenance therapy after symptoms of mood episode had been stabilised by open-label treatment with lamotrigine alone or in combination with other psychotropic medication in patients with bipolar I disorder.


Condition Intervention Phase
Bipolar Disorder
Drug: lamotrigine
Drug: Placebo
Phase III

Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Investigator), Parallel Assignment, Safety/Efficacy Study
Official Title: Study SCA104779, an Evaluation of BW430C (Lamotrigine) Versus Placebo in the Prevention of Mood Episodes in Bipolar I Disorder Patients

Resource links provided by NLM:


Further study details as provided by GlaxoSmithKline:

Primary Outcome Measures:
  • The time from randomization to the time at which the subject is withdrawn from the double blind Phase for any reason (Time to Withdrawal from Study, TWS)- 4 consecutive weeks of treatment [ Time Frame: with in 26 weeks ]

Secondary Outcome Measures:
  • Time to intervention for any mood episode (TIME)- Time to intervention for manic, hypomanic or mixed episode (TIMan)- Time to intervention for depressive episode (TIDep)- CGI-I- CGI-S- HAM-D- YMRS- 4 consecutive weeks of treatment [ Time Frame: within 26weeks ]
  • Time to intervention for any mood episode (TIME) [ Time Frame: within 26 weeks ]
  • Time to intervention for manic, hypomanic or mixed episode (TIMan) [ Time Frame: within 26 weels ]
  • Time to intervention for depressive episode (TIDep) [ Time Frame: with in26 weeks ]
  • Change from baseline of Clinical Global Impressions of Severity (CGI-S) [ Time Frame: 26 weeks ]
  • Clinical Global Impressions of Improvement (CGI-I) [ Time Frame: 26 weeks ]
  • Change from baseline of Hamilton Depression Rating Scale (HAM-D) [ Time Frame: 26 weeks ]
  • Change from baseline of Young Mania Rating Scale (YMRS) [ Time Frame: 26 weeks ]

Enrollment: 103
Study Start Date: November 2007
Study Completion Date: October 2009
Primary Completion Date: October 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
BW430C(lamotrigine): Active Comparator Drug: lamotrigine
lamotrigine 100mg/day or 200mg/day
Placebo: Placebo Comparator Drug: Placebo
placebo once daily

  Eligibility

Ages Eligible for Study:   20 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

At Screening Disease to be studied: Has a diagnosis of following disease as defined by DSM-IV-TR criteria.

  • Bipolar I Disorder, most recent episode depressed(296.5x)
  • Bipolar I Disorder, most recent episode hypomanic(296.40)
  • Bipolar I Disorder, most recent episode manic(296.4x) The diagnosis of mood episode will be made with reference to Mini International Neuropsychiatric Interview: M.I.N.I, Japanese Version.

At Screening

The subject who has a diagnose of bipolar I disorder, most recent episode depressed (296.5x) must meet the following criteria:

  • Is currently experiencing a major depressive episode or has had a major depressive episode as defined by DSM-IV-TR criteria within 60 days of the screening visit and at least one additional major depressive episode and one manic or hypomanic episode, as defined by DSM-IV-TR criteria, within 3 years of enrolment. A well documented history of a mixed episode that meets DSM-IV-TR criteria may be counted as a previous episode.All subjects must have experienced at least one well-documented manic or mixed episode in the past.
  • Has a duration of the most recent/current depressive episode of at least 2 weeks but not longer than 12 months prior to enrolment.
  • The subject without current major depressive episode must have a major depressive episode within 60 days of screening and has depressive symptoms at screening or is under treatment for depressive symptoms, which can be confirmed by medical record, etc.
  • If the subject is currently experiencing a major depressive episode, the subject must have a minimum total score on the HAM-D (17-item scale) of 18 at the screening. This criterion will not apply to the subject with recent depressive episode.

At Screening

The subject who has a diagnose of bipolar I disorder, most recent episode hypomanic(296.4x) or bipolar I disorder, most recent episode manic(296.5x) must meet the following criteria:

  • Has experienced a recent manic or hypomanic episode (current or within 60 days of the Screening Visit) and has had at least one additional manic or hypomanic episode and one depressed episode, as defined by DSM-IV-TR criteria, within three years of enrolment. A well documented history of a mixed episode that meets DSM-IV-TR criteria may be counted as a previous episode. All subjects must have experienced at least one well-documented manic or mixed episode in the past.
  • Has a duration of the index manic episode of at least 1 week (unless hospitalised) or hypomanic episode of at least 4 days. In neither case should the index episode be more than 12 months in duration.
  • The subject current experiencing hypomania episode or without current episode must have a manic episode which can be confirmed by medical record, etc. The subject without current episode must have a episode within 60 days of screening and has manic or hypomanic symptomatology is under treatment for manic or hypomanic symptoms.
  • If the subject's index episode is subject initial manic mood event, subject must have a minimum score of 10 (moderate severity) on the first 11 items of the YMRS at the screening. A threshold YMRS score that indicates significant manic symptoms is not required for patients who previously experienced well-documented DSM-IV-level mania or when the index episode is hypomania or when a subject's index manic or hypomanic episode is documented to have occurred within 60 days of the screening Visit.

At Screening Age: Is at least 20 years of age (at the time of informed consent). At Screening Sex: either sex. Female of child-bearing potential will be eligible for inclusion in this study. However they have to have a negative pregnancy test at the screening visit, agree to further pregnancy testing at the time points determined in study assessments and procedures and practice one of the following methods of contraception from the screening visit until the end of the follow-up examination.

  • Abstinence
  • Injectable progestogen
  • Implants of levonorgestrel
  • Intrauterine device (IUD) or intrauterine system (IUS) that meets the SOP effectiveness criteria as stated in the product label
  • Male partner sterilization (vasectomy with documentation of azoospermia) prior to the female subject's entry into the study, and this male is the sole partner for that subject
  • Double barrier method: condom or occlusive cap (diaphragm or cervical / vault caps) plus spermicidal agent (foam /gel / film / cream / suppository) At Screening In/Out patient: Either At Screening Informed consent: the subject capable of giving written informed consent. At Week 0 of First Phase (titration) If the subject is currently experiencing a major depressive episode, the subject must have a minimum total score at baseline on the HAM-D (17-item scale) of 18 at the start of First Phase. This criterion will not apply to the subject with recent depressive episode.

At Week 0 of First Phase (titration) If the subject's index episode is subject initial manic mood event, subject must have a minimum total score at baseline of 10 (moderate severity) on the first 11 items of the YMRS at the start of First Phase (titration). A threshold YMRS score that indicates significant manic symptoms is not required for patients who previously experienced well-documented DSM-IV-level mania or when the index episode is hypomania or when a subject's index manic or hypomanic episode is documented to have occurred within 60 days of the screening Visit.

At Week 0 of Second Phase (maintenance therapy) Each subject completing 8 to 16 weeks of open-label lamotrigine treatment in the First Phase must meet all of the following inclusion criteria to be eligible for entry into the Second Phase (maintenance therapy, randomization phase).

At Week 0 of Second Phase (maintenance therapy) Has no tolerability problem with lamotrigine at a minimum dosage of 100 mg/day during the final 2 weeks of the First Phase (titration).

At Week 0 of Second Phase (maintenance therapy) Has improved/stabilised during the First Phase (titration) as indicated by a CGI-S score of ≤3 (mildly ill). Once improved, the subject must also demonstrate sustained improvement by achieving a CGI-S score of ≤3 (mildly ill) for at least 4 consecutive weeks of treatment immediately prior to the Second Phase (maintenance therapy) (randomization).

At Week 0 of Second Phase (maintenance therapy) Has demonstrated adequate compliance with the study treatment in the First Phase (titration) (compliance rate: at least 70%).

At Week 0 of Second Phase (maintenance therapy) In/Out patient: Either

Exclusion Criteria:

At Screening Has a DSM-IV-TR diagnosis of rapid cycling and has had more than six mood episodes including depression, mania, hypomania or mixed, in the 12-month period prior to screening. Note: while 4 or more episodes in the past 12 months constitute rapid cycling up to six episodes in the past 12 months are allowed in this protocol.

At Screening Has a DSM-IV-TR diagnosis of bipolar I disorder, most recent episode mixed (296.6x).

At Screening Has a DSM-IV-TR diagnosis of Axis II which would suggest non-responsiveness to pharmacotherapy for bipolar disorder.

At Screening Has a DSM-IV-TR diagnosis of or has received treatment for major depressive disorder, panic disorder, obsessive-compulsive disorder, social phobia, bulimia nervosa, schizophrenia or schizoaffective disorder within 12 months of screening.

At Screening Has a history of substance (including alcohol and drugs) dependence within 12 months of screening or abuse within 1 month of screening according to DSM-IV-TR.

At Screening Patients whose mood episode is due to direct physiological effects of a general medical condition (for example, hypothyroidism, hyperthyroidism) At Screening Has a score of 3 or more on item of the HAM-D related to suicide or is at a high suicidal risk in the judgment of the investigator/sub-investigator.

At Screening Has a history of severe rash or rash due to anti-epileptic drugs. At Screening Patients with severe hepatic/renal/cardiac/pulmonary disorder or hematopoietic disorder. The severity refers to Grade 3 according to the Classification of the Severity of Adverse Experiences (PAB/SD Notification No. 80, dated 29 June 1992).

At Screening Patients have less than 5 years of remission history from clinically significant malignancy (other than e.g. basal cell or squamous cell skin cancer, in-situ carcinoma of cervix or prostate CA in situ).

At Screening Patients with chronic hepatitis typeB and /or typeC which is positive of hepatitis B surface antigen (HBsAg)and/or hepatitis C antibody.

At Screening Has an acute or chronic illness likely to impair drug absorption, distribution, metabolism or excretion or has any unstable physical symptoms likely to require hospitalisation during participation in the study.

At Screening Female patients who are pregnant or lactating, who may be pregnant, or who plan for pregnancy during the study.

At Screening Has a history or current diagnosis of epilepsy. At Screening Has a history of treatment with lamotrigine. At Screening Patients with a history of drug allergy to any ingredient of the test-drug. At Screening Has received an investigational drug within 30 days of screening. At Screening Is morbidly obese (Body Mass Index [BMI] >40) BMI = body weight (kg)/height (m2).

At Screening Patients whom the investigator or sub-investigator considers ineligible for the study.

At Week 0 of First Phase (titration) Has a score of 3 or more on item of the HAM-D related to suicide or is at a high suicidal risk in the judgment of the investigator/sub-investigator and continues .to meet the criteria at the screening visit.

At Week 0 of Second Phase (maintenance therapy) Has signs or symptoms of psychosis. At Week 0 of Second Phase (maintenance therapy) Has a score of 3 or more on item of the HAM-D related to suicide or is at a high suicidal risk in the judgment of the investigator/sub-investigator.

At Week 0 of Second Phase (maintenance therapy) Has had a change in lamotrigine dosage during the final week of the First Phase (titration).

At Week 0 of Second Phase (maintenance therapy) Has a diagnosis of bipolar I disorder, most recent episode of depressed (296.5x) and has experienced manic, hypomanic or mixed symptoms; Has a diagnosis of bipolar I disorder, most recent episode hypomanic (296.40) or most recent episode manic (296.4x) and has experienced depressive symptoms, that require treatment during the First Phase (titration).

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00550407

  Hide Study Locations
Locations
Japan
GSK Investigational Site
Osaka, Japan, 569-1041
GSK Investigational Site
Yamagata, Japan, 999-2221
GSK Investigational Site
Kanagawa, Japan, 238-0042
GSK Investigational Site
Hiroshima, Japan, 737-0023
GSK Investigational Site
Hokkaido, Japan, 060-8648
GSK Investigational Site
Fukuoka, Japan, 807-8555
GSK Investigational Site
Fukuoka, Japan, 814-0180
GSK Investigational Site
Kanagawa, Japan, 216-8511
GSK Investigational Site
Fukuoka, Japan, 802-0001
GSK Investigational Site
Fukuoka, Japan, 802-0006
GSK Investigational Site
Oita, Japan, 874-0011
GSK Investigational Site
Tokyo, Japan, 113-8602
GSK Investigational Site
Tokyo, Japan, 180-0005
GSK Investigational Site
Fukuoka, Japan, 800-0217
GSK Investigational Site
Hokkaido, Japan, 060-0042
GSK Investigational Site
Tokyo, Japan, 170-0002
GSK Investigational Site
Fukuoka, Japan, 810-0004
GSK Investigational Site
Fukuoka, Japan, 812-8582
GSK Investigational Site
Tokyo, Japan, 173-0037
GSK Investigational Site
Fukuoka, Japan, 815-0041
GSK Investigational Site
Kanagawa, Japan, 224-8503
GSK Investigational Site
Tottori, Japan, 680-0011
GSK Investigational Site
Fukuoka, Japan, 830-0011
GSK Investigational Site
Saga, Japan, 842-0192
GSK Investigational Site
Kyoto, Japan, 616-8421
GSK Investigational Site
Kanagawa, Japan, 231-0023
GSK Investigational Site
Kumamoto, Japan, 861-8002
GSK Investigational Site
Osaka, Japan, 533-0005
GSK Investigational Site
Kanagawa, Japan, 225-0011
GSK Investigational Site
Tokyo, Japan, 166-0003
GSK Investigational Site
Nara, Japan, 634-8522
GSK Investigational Site
Chiba, Japan, 289-2511
GSK Investigational Site
Oita, Japan, 879-5593
GSK Investigational Site
Aichi, Japan, 470-1141
GSK Investigational Site
Tokyo, Japan, 183-0042
GSK Investigational Site
Tokyo, Japan, 152-0012
GSK Investigational Site
Tokyo, Japan, 154-0004
GSK Investigational Site
Tokyo, Japan, 187-8551
GSK Investigational Site
Tokyo, Japan, 151-0053
GSK Investigational Site
Chiba, Japan, 272-8516
GSK Investigational Site
Kanagawa, Japan, 221-0835
GSK Investigational Site
Gunma, Japan, 375-0017
GSK Investigational Site
Gunma, Japan, 377-0055
GSK Investigational Site
Saitama, Japan, 332-0012
GSK Investigational Site
Tokyo, Japan, 100-0006
GSK Investigational Site
Hiroshima, Japan, 734-8551
GSK Investigational Site
Osaka, Japan, 590-0018
GSK Investigational Site
Okayama, Japan, 700-8558
GSK Investigational Site
Tokyo, Japan, 154-0012
GSK Investigational Site
Tokyo, Japan, 190-0023
GSK Investigational Site
Ibaraki, Japan, 311-3117
GSK Investigational Site
Tottori, Japan, 682-0023
GSK Investigational Site
Chiba, Japan, 260-8677
GSK Investigational Site
Osaka, Japan, 570-8507
GSK Investigational Site
Hokkaido, Japan, 002-8029
GSK Investigational Site
Mie, Japan, 515-0044
GSK Investigational Site
Mie, Japan, 510-8575
GSK Investigational Site
Oita, Japan, 879-7501
Sponsors and Collaborators
GlaxoSmithKline
Investigators
Study Director: GSK Clinical Trials GlaxoSmithKline
  More Information

No publications provided

Responsible Party: GSK ( Study Director )
Study ID Numbers: SCA104779
Study First Received: October 26, 2007
Last Updated: November 12, 2009
ClinicalTrials.gov Identifier: NCT00550407     History of Changes
Health Authority: Japan: Ministry of Health, Labor and Welfare

Keywords provided by GlaxoSmithKline:
Lamotrigine
Bipolar I disorder
Prevention of relapse or recurrence of a mood episode

Additional relevant MeSH terms:
Disease
Molecular Mechanisms of Pharmacological Action
Bipolar Disorder
Calcium Channel Blockers
Cardiovascular Agents
Pharmacologic Actions
Membrane Transport Modulators
Affective Disorders, Psychotic
Pathologic Processes
Mental Disorders
Therapeutic Uses
Mood Disorders
Lamotrigine
Central Nervous System Agents
Anticonvulsants

ClinicalTrials.gov processed this record on November 30, 2009