Now Available: Final Rule for FDAAA 801 and NIH Policy on Clinical Trial Reporting

Tolerability, Safety and Efficacy of Flexibly Dosed Paliperidone ER in Patients With Schizophrenia (PERFLEX)

This study has been completed.
Information provided by (Responsible Party):
Janssen-Cilag, S.A. Identifier:
First received: November 7, 2012
Last updated: February 4, 2013
Last verified: February 2013
The purpose of this study is to evaluate efficacy, safety and tolerability of flexible, once-daily doses of paliperidone extended-release (ER) in patients with schizophrenia from Argentina and Colombia that previously failed treatment with other antipsychotic agents.

Condition Intervention Phase
Drug: Paliperidone ER
Phase 4

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Open-label Prospective Trial to Explore the Tolerability, Safety and Efficacy of Flexibly Dosed Paliperidone ER in Subjects With Schizophrenia

Resource links provided by NLM:

Further study details as provided by Janssen-Cilag, S.A.:

Primary Outcome Measures:
  • Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) Score [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    The PANSS is a 30-item scale designed to assess various symptoms of schizophrenia. The 30 symptoms are rated on a 7-point scale that ranges from 1 (absent) to 7 (extreme psychopathology). The PANSS total score consists of the sum of all 30 PANSS items and ranges from 30 to 210. Higher scores indicate worsening.

Secondary Outcome Measures:
  • Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) - Positive Subscale Score [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    The PANSS Positive Subscale assesses seven positive-symptoms of schizophrenia. Positive symptoms refer to an excess or distortion of normal functions. The symptoms are rated on a 7-point scale, with a range of 7 (absent) to 49 (extreme psychopathology).

  • Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) - Negative Subscale Score [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    The PANSS Negative Subscale assesses seven negative-symptoms of schizophrenia. Negative symptoms represent a diminution or loss of normal functions. The symptoms are rated on a 7-point scale, with a range of 7 (absent) to 49 (extreme psychopathology).

  • Change From Baseline in Total Positive and Negative Syndrome Scale (PANSS) - General Psychopathology Subscale Score [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    The PANSS General Psychopathology Subscale Score assesses 16 general psychopathology symptoms. The symptoms are rated on a 7-point scale, with a range of 16 (absent) to 112 (extreme psychopathology).

  • Clinical Global Impression-Severity (CGIS) [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    The CGI-S rating scale is a 7 point global assessment that measures the clinician's impression of the severity of illness exhibited by a patient. A rating of 1 is equivalent to "Normal, not at all ill" and a rating of 7 is equivalent to "Among the most extremely ill patients". Higher scores indicate worsening.

  • Personal and Social Performance (PSP) Scale [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    This PSP assesses the degree of a patient's dysfunction within 4 domains of behavior: socially useful activities, personal and social relationships, self-care, and disturbing and aggressive behavior. The score ranges from 1 to 100, divided into 10 equal intervals to rate the degree of difficulty (i, absent to vi, very severe) in each of the 4 domains. Based on the four domains there will be one total score. Patients with a score of 71 to 100 have a mild degree of difficulty; from 31 to 70, varying degrees of disability; =< 30, functioning so poorly as to require intensive supervision.

  • Health Status as Measured by Self-rated Health Status Survey SF-36 [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    The SF-36 is designed to examine a person's perceived health status. The SF-36 includes one multi-item scale measuring eight health concepts: vitality, physical functioning, bodily pain, general health perceptions, physical role-, emotional role-, social role functioning, and mental health. Answers to each question are scored and summed to produce raw scale scores for each health concept which are then transformed to a 0 - 100 scale, a high score defining a more favorable health state. An aggregate summary measure is calculated by averaging the scores from the eight health concepts.

  • Sleep Evaluation Scale [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    This self-administered scale rates the quality of sleep. Patients will indicate on an 11-point scale how well they have slept in the previous 7 days, from 0 (very badly) to 10 (very well).

  • Daytime Drowsiness Evaluation Scale [ Time Frame: Baseline, Week 26 ] [ Designated as safety issue: No ]
    This self-administered scale rates the daytime drowsiness. Patients will indicate on an 11-point scale how often they have felt drowsy within the previous 7 days, from 0 (not at all) to 10 (all the time).

Enrollment: 95
Study Start Date: February 2008
Study Completion Date: November 2009
Primary Completion Date: November 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Paliperidone ER Drug: Paliperidone ER
The recommended Paliperidone extended-release (ER) dose will be 6 mg/day. Some patients may benefit from higher or lower doses, in the range of 3 to 12 mg/day. Paliperidone ER will be administered orally once daily. Adjustment of the dosage will be done at the investigator's discretion.

Detailed Description:
This is a single arm (one group of patients), open-label (all people know the identity of the intervention) multicenter 6-month study. Throughout the study flexible dosing of paliperidone ER in a range of 3 to 12 mg/day may be used. Flexible dosing will allow investigators to adjust the dosage of each patient based on the individual needs. Patients will receive 3, 6, 9 or 12 mg of paliperidone ER once daily for 6 months. The tablets will be taken orally. Adjustment of the dosage will be done at the investigator's discretion, based on the individual patient's clinical response and tolerability to the study drug.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Genders Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient meets the criteria for schizophrenia
  • Patient is previously non-acute and has been given an adequate dose of an appropriate oral antipsychotic for an adequate period of time prior to enrollment, but previous treatment is considered unsuccessful due to one or more of the following reasons: lack of efficacy, lack of tolerability or safety, lack of compliance and/or other reasons to switch to another antipsychotic medication
  • Patient is healthy on the basis of a physical examination and vital signs at screening
  • Women must be postmenopausal for at least 1 year, surgically sterile, abstinent, or, if sexually active, agree to practice an effective method of birth control before entry and throughout the study

Exclusion Criteria:

  • Patients on clozapine, any conventional depot neuroleptic or risperidone long-acting injections during the last 3 months
  • Patients with serious unstable medical condition, including known clinically relevant laboratory abnormalities
  • Patients with history or current symptoms of tardive dyskinesia and neuroleptic malignant syndrome
  • Patients judged to be at high risk for adverse events, violence, or self-harm
  • Patients with known hypersensitivity to paliperidone ER or to risperidone
  • Patients with a current use or known history (over the past 6 months) of substance dependence
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01724359

Buenos Aires N/A, Argentina
Buenos Aires, Argentina
Rosario, Argentina
Bogota, Colombia
Cali, Colombia
Medellin, Colombia
Sponsors and Collaborators
Janssen-Cilag, S.A.
Study Director: Janssen-Cilag S.A. Clinical Trial Janssen-Cilag, S.A.
  More Information

Responsible Party: Janssen-Cilag, S.A. Identifier: NCT01724359     History of Changes
Other Study ID Numbers: CR017413  R076477SCH3029  R076477SCH3036 
Study First Received: November 7, 2012
Results First Received: November 27, 2012
Last Updated: February 4, 2013
Health Authority: Argentina: Administracion Nacional de Medicamentos, Alimentos y Tecnologia Medica
Colombia: INVIMA Instituto Nacional de Vigilancia de Medicamentos y Alimentos

Keywords provided by Janssen-Cilag, S.A.:
Paliperidone extended-release (ER)
Antipsychotic agents

Additional relevant MeSH terms:
Schizophrenia Spectrum and Other Psychotic Disorders
Mental Disorders
Paliperidone Palmitate
Antipsychotic Agents
Tranquilizing Agents
Central Nervous System Depressants
Physiological Effects of Drugs
Psychotropic Drugs
Serotonin 5-HT2 Receptor Antagonists
Serotonin Antagonists
Serotonin Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Dopamine D2 Receptor Antagonists
Dopamine Antagonists
Dopamine Agents processed this record on January 18, 2017