Study of Lurasidone in Treating Antipsychotic Naive or Quasi-Naive Children and Adolescents - Full Text View

Purpose

The overarching purpose of this pilot study is to collect preliminary data regarding the variability of weight gain associated with lurasidone (Latuda©) treatment of antipsychotic naive children and adolescents in order to inform decisions about including a lurasidone arm in a future large scale trial of different approaches to minimize antipsychotic associated weight gain in the pediatric population. In adults, lurasidone appears to cause minimal weight gain. The participants will be 6-19 years old with psychotic spectrum, mood spectrum, or autism spectrum disorders. They will have 4 weeks or less of lifetime antipsychotic exposure.

Condition	Intervention	Phase
Schizophrenia Schizoaffective Disorder Schizophreniform Disorder Psychosis NOS Autistic Disorder Asperger Syndrome Child Development Disorders, Pervasive Bipolar I Disorder Bipolar II Disorder Mood Disorder NOS Severe Major Depression With Psychotic Features Single Episode Major Depression Without Psychotic Symptoms Severe Mood Disorder With Psychotic Features	Drug: Latuda©	Phase 2


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 Pilot Study of Lurasidone in Treating Antipsychotic Naive or Quasi-Naive Children and Adolescents

Resource links provided by NLM:

Genetics Home Reference related topics: Asperger syndrome

MedlinePlus related topics: Autism Spectrum Disorder Mental Disorders Mood Disorders Psychotic Disorders Toddler Development

Drug Information available for: Lurasidone

U.S. FDA Resources

Further study details as provided by University of North Carolina, Chapel Hill:

Primary Outcome Measures:

Change in Weight [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
Percent change in weight from Baseline to Week 12 will be assessed as the primary outcome measure. Subjects will be asked to step on a special scale called a TANITA which will calculate weight, fat mass at each study visit.

Secondary Outcome Measures:

Proportion of Participants Completing Treatment [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
Data will be collected on why participants terminated the study. If terminated early, the specific reason will be collected such as efficacy or tolerability.
Changes in Efficacy Measures [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
Efficacy measures including the Brief Psychiatric Rating Scale (BPRS-C) which measures symptomatology on five subscales including depression/anxiety, psychomotor excitation/mania, behavior problems, thinking disturbance, and organicity and the Aberrant Behavior Checklist-Community (ABC-C) which focuses on problem behaviors in five subdomains, including irritability, attention, repetitive behaviors, unusual speech, and social withdrawal.
Side Effects [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
Assessment of the medication side effects associated with lurasidone (Latuda©) in children and adolescents.
Overall Clinical Improvement [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
Overall psychiatric functioning will be assessed with the severity (CGI-S) and improvement (CGI-I) subscales of the CGI. CGI-S items are rated from 1 (normal, not ill) to 7 (very severely ill). CGI-I items are rated from 1 (very much improved) to 7 (very much worse).


Enrollment:	10
Study Start Date:	December 2012
Study Completion Date:	August 2014
Primary Completion Date:	August 2014 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Flexible Dose Latuda© Lurasidone (Latuda©)dose will be determined solely by the clinician in accordance with the best interests of each participant.	Drug: Latuda© All subjects will be started on 20-40mg of Latuda© at night (suggested intake with food). Subsequently, the dose may be increased as clinically indicated and based on tolerability every 7 days by 20-40mg to a maximum of 160mg per day with food which may be given as a single or twice daily dose depending on participant's preference. The maintenance dose will be determined solely by the clinician in accordance with the best interests of each participant. Other Name: Lurasidone Hydrochloride tablets

Arms

Assigned Interventions

Experimental: Flexible Dose Latuda©

Lurasidone (Latuda©)dose will be determined solely by the clinician in accordance with the best interests of each participant.

Drug: Latuda©

All subjects will be started on 20-40mg of Latuda© at night (suggested intake with food). Subsequently, the dose may be increased as clinically indicated and based on tolerability every 7 days by 20-40mg to a maximum of 160mg per day with food which may be given as a single or twice daily dose depending on participant's preference. The maintenance dose will be determined solely by the clinician in accordance with the best interests of each participant.

Other Name: Lurasidone Hydrochloride tablets

Detailed Description:

This is a multi-site, 12-week, open-label study assessing the weight and metabolic changes associated with lurasidone treatment. Antipsychotic naive subjects will start open-label treatment by following a flexible titration schedule. Quasi-antipsychotic naive subjects (less than 4 weeks of total AP treatment) will be started on lurasidone and tapered off the other antipsychotic over an estimated 4 weeks depending on the dose and tolerability of the prior antipsychotic. Other psychoactive medications including antidepressants, benzodiazepines, stimulants, alpha-2 agonists, and mood stabilizers are allowed as long as the dose is not changed, unless it is clinically necessary. Assessments of weight, efficacy, and side effects are conducted at baseline, week 2, week 4, week 8, and week 12. The primary outcome is percent change in weight. The secondary outcomes include psychiatric efficacy measures and side effects.

Eligibility


Ages Eligible for Study:	6 Years to 19 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Male and female children and adolescents between 6 and 19 years of age of any race or ethnicity
Subject must meet DSM-IV-TR criteria for a psychotic spectrum, mood spectrum or autism spectrum disorder as defined by one of the following diagnoses:
- schizophrenia (any type)
- schizoaffective disorder
- schizophreniform disorder
- psychosis NOS
- autistic disorder with significant irritability/aggression (ABC-C Irritability subscale score of greater than or equal to 18)
- Asperger syndrome with significant irritability/aggression (ABC-C Irritability subscale score of greater than or equal to 18)
- pervasive developmental disorder NOS with significant irritability/aggression (ABC-C Irritability subscale score of greater than or equal to 18)
- bipolar type I
- bipolar type II
- mood disorder NOS
- major depression with psychotic features
- major depression (unresponsive to 2 different antidepressants)
- severe mood dysregulation (SMD) according to Leibenluft and colleagues broad spectrum bipolar disorder
Subjects must have ≤ 4 weeks of lifetime exposure to an antipsychotic medication at any dosage. These medications include olanzapine (Zyprexa©), quetiapine (Seroquel©), risperidone (Risperdal©), ziprasidone (Geodon©), aripiprazole (Abilify©), asenapine (Saphris©), iloperidone (Fanapt©), lurasidone (Latuda©), haloperidol, chlorpromazine, perphenazine, fluphenazine, thiothixene, or clozapine
Subjects on other psychoactive medications are asked not to change dose of those medications during the course of the study unless clinically necessary
Sexually active girls must agree to use two effective forms of birth control (i.e. hormonal or spermicidal and barrier) or be abstinent)
Primary caretaker is able to participate in study appointments as is clinically indicated
Ability of child to participate in all aspects of the protocol per investigator's clinical judgment
After considering all aspects of study participation the subject (if an adult) or subject's parent or LAR must consent to participation
After considering all aspects of study participation, the subject must assent to participation if it is developmentally appropriate to obtain assent

Exclusion Criteria:

Based on current or lifetime DSM-IV-TR criteria, a diagnosis of Eating Disorder (Anorexia Nervosa or Bulimia Nervosa)
Based on DSM-IV-TR criteria, a diagnosis of Substance Dependence Disorder (other than tobacco dependence) within the past month
Treatment with the following concomitant medications: strong CYP3A4 inhibitors (ex: Ketoconazole), strong CYP3A4 inducers (ex: Rifampin)
Current or past treatment with lurasidone (Latuda©) that resulted in a non-response or intolerance
Females who are pregnant or breast-feeding
Ongoing or previously undisclosed child abuse requiring new department of social service intervention
Subjects who, in the Investigator's opinion, might not be suitable for the study

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 ClinicalTrials.gov identifier: NCT01731119

Locations


United States, Maryland
Johns Hopkins University
Baltimore, Maryland, United States, 21205
University of Maryland
Baltimore, Maryland, United States, 21205
United States, New York
The Zucker Hillside Hospital
Glen Oaks, New York, United States, 11004
United States, North Carolina
University of North Carolina
Chapel Hill, North Carolina, United States, 27517

Sponsors and Collaborators

University of North Carolina, Chapel Hill

Foundation of Hope, North Carolina

Johns Hopkins University

University of Maryland

The Zucker Hillside Hospital

Investigators


Principal Investigator:	Linmarie Sikich, MD	University of North Carolina, Chapel Hill
Principal Investigator:	Mark Riddle, MD	Johns Hopkins University
Principal Investigator:	Christoph Correll, MD	The Zucker Hillside Hospital
Principal Investigator:	Gloria Reeves, MD	University of Maryland

More Information

No publications provided


Responsible Party:	Linmarie Sikich, MD, Associate Professor of Psychiatry, University of North Carolina, Chapel Hill
ClinicalTrials.gov Identifier:	NCT01731119 History of Changes
Other Study ID Numbers:	12-2302
Study First Received:	November 14, 2012
Last Updated:	August 24, 2014
Health Authority:	United States: Food and Drug Administration

Keywords provided by University of North Carolina, Chapel Hill:


Latuda,lurasidone,antipsychotics,autism, mood, psychosis

Additional relevant MeSH terms:


Asperger Syndrome Autistic Disorder Child Development Disorders, Pervasive Depression Depressive Disorder, Major Developmental Disabilities Mental Disorders Mood Disorders Psychotic Disorders Behavioral Symptoms Depressive Disorder	Mental Disorders Diagnosed in Childhood Schizophrenia and Disorders with Psychotic Features Antipsychotic Agents Central Nervous System Agents Central Nervous System Depressants Pharmacologic Actions Physiological Effects of Drugs Psychotropic Drugs Therapeutic Uses Tranquilizing Agents

ClinicalTrials.gov processed this record on March 03, 2015