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A Study of Aripiprazole Lauroxil or Paliperidone Palmitate for the Treatment of Schizophrenia

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ClinicalTrials.gov Identifier: NCT03345979
Recruitment Status : Completed
First Posted : November 17, 2017
Results First Posted : August 11, 2020
Last Update Posted : August 11, 2020
Sponsor:
Information provided by (Responsible Party):
Alkermes, Inc.

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor);   Primary Purpose: Treatment
Condition Schizophrenia
Interventions Combination Product: Aripiprazole Lauroxil
Drug: Paliperidone Palmitate
Enrollment 200
Recruitment Details  
Pre-assignment Details Of the 200 patients enrolled and randomized to treatment, there were 195 patients included in the full analysis set. These were patients who randomized, received 1 dose study drug and had at least one post-baseline Positive and Negative Syndrome Scale (PANSS) assessment.
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Period Title: Overall Study
Started 99 101
Completed 56 43
Not Completed 43 58
Reason Not Completed
Withdrawal by Subject             20             31
Adverse Event             10             11
Lost to Follow-up             8             9
Lack of Efficacy             4             2
Protocol Violation             1             3
Physician Decision             0             2
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate Total
Hide Arm/Group Description Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter Total of all reporting groups
Overall Number of Baseline Participants 99 101 200
Hide Baseline Analysis Population Description
[Not Specified]
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 99 participants 101 participants 200 participants
43.5  (9.67) 43.4  (10.83) 43.4  (10.25)
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 99 participants 101 participants 200 participants
Female
26
  26.3%
25
  24.8%
51
  25.5%
Male
73
  73.7%
76
  75.2%
149
  74.5%
Ethnicity (NIH/OMB)  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 99 participants 101 participants 200 participants
Hispanic or Latino
8
   8.1%
11
  10.9%
19
   9.5%
Not Hispanic or Latino
91
  91.9%
90
  89.1%
181
  90.5%
Unknown or Not Reported
0
   0.0%
0
   0.0%
0
   0.0%
Race (NIH/OMB)  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 99 participants 101 participants 200 participants
American Indian or Alaska Native
0
   0.0%
0
   0.0%
0
   0.0%
Asian
2
   2.0%
4
   4.0%
6
   3.0%
Native Hawaiian or Other Pacific Islander
0
   0.0%
0
   0.0%
0
   0.0%
Black or African American
72
  72.7%
78
  77.2%
150
  75.0%
White
25
  25.3%
17
  16.8%
42
  21.0%
More than one race
0
   0.0%
2
   2.0%
2
   1.0%
Unknown or Not Reported
0
   0.0%
0
   0.0%
0
   0.0%
Positive and Negative Syndrome Scale (PANSS) Total Score   [1] [2] 
Mean (Standard Deviation)
Unit of measure:  Units on a scale
Number Analyzed 96 participants 99 participants 195 participants
94.1  (9.04) 94.6  (8.41) 94.4  (8.71)
[1]
Measure Description: The Positive and Negative Syndrome Scale (PANSS) contains 30 questions, each containing an answer range of 1-7. A total PANSS score can range from between 30 to 210; a higher score indicates a worse disease condition.
[2]
Measure Analysis Population Description: FAS population includes those who were randomized and received at least one dose of study drug and have at least one post-baseline Positive and Negative Syndrome Scale (PANSS) assessment
1.Primary Outcome
Title Change From Baseline in the Positive and Negative Syndrome Scale (PANSS) Total Score at Week 4
Hide Description Change within treatment groups of Positive and Negative Syndrome Scale (PANSS) total score between baseline and week 4 based on the observed data without imputation for missing data. The PANSS scale contains 30 questions, each containing an answer range of 1-7. A total PANSS score can range from between 30 to 210; a higher score indicates a worse disease condition.
Time Frame Baseline and 4 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
The analysis is based on the subjects who had both baseline and observed week 4 Positive and Negative Syndrome Scale (PANSS) data (160 participants).
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description:
Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter
Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Overall Number of Participants Analyzed 80 80
Mean (Standard Deviation)
Unit of Measure: units on a scale
-17.4  (11.57) -20.1  (13.72)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Aripiprazole Lauroxil
Comments [Not Specified]
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <.001
Comments [Not Specified]
Method t-test, 2 sided
Comments [Not Specified]
Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Paliperidone Palmitate
Comments [Not Specified]
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <.001
Comments [Not Specified]
Method t-test, 2 sided
Comments [Not Specified]
2.Secondary Outcome
Title Least Squares Mean Change in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 4
Hide Description Least squares mean change in Positive and Negative Syndrome Scale (PANSS) between at 4 weeks from Mixed Models Repeated Measures (MMRM). The PANSS scale contains 30 questions, each containing an answer range of 1-7. A total PANSS score can range from between 30 to 210; a higher score indicates a worse disease condition
Time Frame Baseline and 4 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
The analysis is based on the subjects who had both baseline and observed week 4 Positive and Negative Syndrome Scale (PANSS) data (160 participants).
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description:
Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter
Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Overall Number of Participants Analyzed 80 80
Least Squares Mean (Standard Error)
Unit of Measure: units on a scale
-17.3  (1.28) -19.3  (1.25)
3.Secondary Outcome
Title Change in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 9
Hide Description Change within treatment groups from baseline Positive and Negative Syndrome Scale (PANSS) and 9 weeks based on the observed data without imputation for missing data. The PANSS scale contains 30 questions, each containing an answer range of 1-7. A total PANSS score can range from between 30 to 210; a higher score indicates a worse disease condition.
Time Frame Baseline and 9 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
The analysis is based on the subjects who had both baseline and observed week 9 Positive and Negative Syndrome Scale (PANSS) data (131 participants).
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description:
Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter
Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Overall Number of Participants Analyzed 69 62
Mean (Standard Deviation)
Unit of Measure: units on a scale
-19.8  (11.61) -22.5  (13.98)
4.Secondary Outcome
Title Change in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 25
Hide Description Change within treatment groups at baseline Positive and Negative Syndrome Scale (PANSS) and at 25 weeks based on the observed data without imputation for missing data. The PANSS scale contains 30 questions, each containing an answer range of 1-7. A total PANSS score can range from between 30 to 210; a higher score indicates a worse disease condition
Time Frame Baseline and 25 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
The analysis is based on the subjects who had both baseline and observed week 25 Positive and Negative Syndrome Scale (PANSS) data (99 participants).
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description:
Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter
Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Overall Number of Participants Analyzed 56 43
Mean (Standard Deviation)
Unit of Measure: units on a scale
-23.3  (11.25) -21.7  (14.37)
5.Secondary Outcome
Title Least Squares Mean Change in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 9
Hide Description Least squares mean change from baseline Positive and Negative Syndrome Scale (PANSS) and 9 weeks from Mixed Models Repeated Measures (MMRM).The PANSS scale contains 30 questions, each containing an answer range of 1-7. A total PANSS score can range from between 30 to 210; a higher score indicates a worse disease condition
Time Frame Baseline and 9 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
The analysis is based on the subjects who had both baseline and observed week 9 PANSS data (131 participants).
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description:
Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter
Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Overall Number of Participants Analyzed 69 62
Least Squares Mean (Standard Error)
Unit of Measure: units on a scale
-18.8  (1.33) -21.5  (1.34)
6.Secondary Outcome
Title Least Squares Mean Change in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 25
Hide Description Least squares mean change in Positive and Negative Syndrome Scale (PANSS) total score at week 25 from Mixed Models Repeated Measures. The PANSS scale contains 30 questions, each containing an answer range of 1-7. A total PANSS score can range from between 30 to 210; a higher score indicates a worse disease condition
Time Frame Baseline and 25 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
The analysis is based on the subjects who had both baseline and observed week 25 Positive and Negative Syndrome Scale (PANSS) data (99 participants).
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description:
Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter
Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Overall Number of Participants Analyzed 56 43
Least Squares Mean (Standard Error)
Unit of Measure: units on a scale
-22.0  (1.42) -21.1  (1.53)
7.Secondary Outcome
Title Number of Participants With Serious and Non-serious Adverse Events (AEs)
Hide Description [Not Specified]
Time Frame Up to 25 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Participants who received at least one dose of study drug.
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description:
Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter
Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
Overall Number of Participants Analyzed 99 101
Measure Type: Count of Participants
Unit of Measure: Participants
69
  69.7%
72
  71.3%
Time Frame Adverse event data was collected over 25 weeks.
Adverse Event Reporting Description Adverse event collection was based on investigator's observation and reporting from subjects.
 
Arm/Group Title Aripiprazole Lauroxil Paliperidone Palmitate
Hide Arm/Group Description Aripiprazole lauroxil (AL)1-day initiation regimen (30mg oral aripiprazole + intramuscular injection aripiprazole lauroxil nano-cyrstalline milled dispersion [AL-NCD]) on day 1, followed by 1064mg intramuscular injection aripiprazole lauroxil on day 8 and every 2 months thereafter Paliperidone palmitate (PP) initiation dosing (234mg intramuscular injection on day 1 + 156mg intramuscular injection on day 8), followed by 156mg intramuscular injection paliperidone palmitate every month thereafter
All-Cause Mortality
Aripiprazole Lauroxil Paliperidone Palmitate
Affected / at Risk (%) Affected / at Risk (%)
Total   0/99 (0.00%)      0/101 (0.00%)    
Hide Serious Adverse Events
Aripiprazole Lauroxil Paliperidone Palmitate
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   8/99 (8.08%)      7/101 (6.93%)    
Blood and lymphatic system disorders     
Leukocytosis   1/99 (1.01%)  1 0/101 (0.00%)  0
Injury, poisoning and procedural complications     
Alcohol poisoning   0/99 (0.00%)  0 1/101 (0.99%)  1
Overdose   0/99 (0.00%)  0 1/101 (0.99%)  1
Road traffic accident   0/99 (0.00%)  0 1/101 (0.99%)  1
Metabolism and nutrition disorders     
Hypercalcaemia   1/99 (1.01%)  1 0/101 (0.00%)  0
Musculoskeletal and connective tissue disorders     
Bone deformity   0/99 (0.00%)  0 1/101 (0.99%)  1
Nervous system disorders     
Dystonia   0/99 (0.00%)  0 1/101 (0.99%)  1
Generalised tonic-clonic seizure   1/99 (1.01%)  1 0/101 (0.00%)  0
Psychiatric disorders     
Schizophrenia   5/99 (5.05%)  5 2/101 (1.98%)  2
Psychotic disorder   2/99 (2.02%)  2 0/101 (0.00%)  0
Suicide attempt   1/99 (1.01%)  1 1/101 (0.99%)  1
Depression   0/99 (0.00%)  0 1/101 (0.99%)  3
Psychotic symptom   0/99 (0.00%)  0 1/101 (0.99%)  1
Suicidal ideation   1/99 (1.01%)  1 0/101 (0.00%)  0
Renal and urinary disorders     
Renal failure   1/99 (1.01%)  1 0/101 (0.00%)  0
Indicates events were collected by systematic assessment
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 5%
Aripiprazole Lauroxil Paliperidone Palmitate
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   39/99 (39.39%)      50/101 (49.50%)    
General disorders     
Injection Site Pain   17/99 (17.17%)  28 25/101 (24.75%)  40
Investigations     
Weight increased   9/99 (9.09%)  9 17/101 (16.83%)  17
Nervous system disorders     
Akathisia   9/99 (9.09%)  9 11/101 (10.89%)  13
Headache   8/99 (8.08%)  9 8/101 (7.92%)  8
Somnolence   4/99 (4.04%)  4 7/101 (6.93%)  8
Dystonia   3/99 (3.03%)  3 6/101 (5.94%)  6
Indicates events were collected by systematic assessment
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Should an Investigator desire to disclose study results, Sponsor will review the results disclosure prior to public release and can embargo the disclosure for a period of at least 60 days. Revisions to the disclosure will be negotiated in good faith. For a multicenter study the Investigators agree to publish/publicly present the results together with the other sites for the 12 month period after study results are available unless Sponsor grants written permission in advance.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: Eva Stroynowski
Organization: Alkermes, Inc
Phone: 7816097000
EMail: eva.stroynowski@alkermes.com
Layout table for additonal information
Responsible Party: Alkermes, Inc.
ClinicalTrials.gov Identifier: NCT03345979    
Other Study ID Numbers: ALK9072-A306
First Submitted: November 14, 2017
First Posted: November 17, 2017
Results First Submitted: June 30, 2020
Results First Posted: August 11, 2020
Last Update Posted: August 11, 2020