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SchizophreniaPhase 3SPECTRUMNCT00640601

Study Evaluating the Clinical Benefit of SEROQUEL XR in Subjects With Schizophrenia

A Phase 3 study testing Quetiapine Fumarate Extended- Release in people with Schizophrenia, run by AstraZeneca at 36 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A Multicentre, Open-label, Prospective Long-term Study Evaluating the Clinical Benefit and Effectiveness of SEROQUEL XR® (Quetiapine Fumarate Extended-Release Tablets) in Subjects with Schizophrenia. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Schizophrenia
What is being tested?
Quetiapine Fumarate Extended- Release
Type of treatment
Pill or oral medicine
How many people
331 participants
Where
36 sitesin 4 countries
Study dates
Mar 2008to Jul 2010
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Provision of written informed consent before initiation of any study related procedures.
  • Male and female subjects aged 18 to 65 years, inclusive.
  • Documented clinical diagnosis meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for any of the following: Schizophrenia DSM-IV, catatonic 295.20, disorganised 295.10, paranoid 295.30 and undifferentiated 295.90.
  • Outpatient status.
  • Subjects who in their own and/or in the Principal Investigator's opinion, consider their ongoing antipsychotic treatment inadequate because of insufficient efficacy, poor tolerance, and/or non acceptability of their actual dosage regimen (eg. b.i.d, t.i.d, etc).
  • Monotherapy with current antipsychotic for at least 7 days prior to initiating treatment (ie, cannot be on more than one antipsychotic during the 7 day period prior to initiating study medication). Note: Subjects on a b.i.d regimen of seroquel IR for 7 days prior to enrolment are eligible to participate in the study.
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  • Female subjects of childbearing potential must have a negative serum pregnancy test at enrolment and be willing to use a reliable method of birth control, ie, barrier method, oral contraceptive, implant, dermal contraception, long-term injectable contraceptive, intrauterine device, or tubal ligation during the study.
  • Capable to make treatment decisions, including being able to understand and comply with the requirements of the study, and judged as such by the Principal Investigator.
  • Be able to read and write either English or French at a grade 7 proficiency level.

Who cannot join

  • First episode, drug naive schizophrenic subjects.
  • Meeting the criteria for any other (than schizophrenia) DSM-IV Axis I diagnosis, concomitant organic mental disorder or mental retardation that in the opinion of the Principal Investigator may interfere with study conduct or interpretation.
  • Substance/alcohol dependence or abuse at enrolment [except dependence in full remission (>3 months) and except caffeine and nicotine dependence] as defined by DSM-IV criteria. A urine drug screen will be performed. The Principal Investigator will evaluate the results along with medical history to determine if the patient meets DSM-IV criteria for substance abuse or dependence. However, a single urine toxicology screen for cocaine, heroin, methamphetamine or PCP will lead to exclusion.
  • Subjects requiring treatment with another antipsychotic agent than investigational product during study.
  • Subjects on seroquel IR once daily.
  • Known lack of response to clozapine or treatment with clozapine within 4 weeks prior to enrolment.
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  • Known intolerance to seroquel IR.
  • Subjects requiring treatment with disallowed medication following enrolment into the study.
  • Subjects requiring treatment for epilepsy.
  • Subjects who pose an imminent risk of suicide or danger to themselves or others, as judged by the Principal Investigator.
  • Pregnancy or lactation.
  • A thyroid-stimulating hormone (TSH) concentration more than 10% above the upper limit of the normal range of the laboratory used for sample analysis whether or not the patient is being treated for hypothyroidism or hyperthyroidism.
  • Use of a depot or long-acting injectable antipsychotic drug within 1 dosing interval before Day 1 of treatment or during treatment.
  • Use of drugs that induce or inhibit the hepatic metabolising cytochrome P450 3A4 enzymes within 14 days of the screening assessment period (Day -7 to 0). See Table 5.
  • History of idiopathic or drug-induced agranulocytosis.
  • A QTc interval longer than 450 msec (calculated using the Fridericia correction for heart rate) or ECG considered to show cardiac abnormality at enrolment as determined by a centrally located, experienced cardiologist, and confirmed by the Principal Investigator as clinically significant.
  • Evidence of clinically relevant disease (eg, renal, hepatic, autonomic, endocrine, hematologic or ophthalmologic impairment, significant coronary artery disease, congestive heart failure, cerebrovascular disease, viral hepatitis B or C, acquired immunodeficiency syndrome [AIDS] or cancer) or a clinical finding that is unstable or that, in the opinion of the Principal Investigator, would be negatively affected by the investigational product or that would affect the investigational product.
  • Laboratory test results outside the reference range considered by the Principal Investigator to be clinically significant and potentially interfere with the study outcome.
  • A patient with Diabetes Mellitus (DM) fulfilling one of the following criteria:
  • Unstable DM defined as HbA1c >8.5% at enrolment. Admitted to hospital for treatment of DM or DM related illness in past 12 weeks.
  • Not under care of physician responsible for patient's DM care.
  • Physician responsible for patient's DM care has not indicated that patient's DM is controlled.
  • Physician responsible for patient's DM care has not approved patient's participation in the study.
  • Has not been on the same dose of oral hypoglycemic drug(s) and/or diet for the four (4) weeks prior to randomisation. For thiazolidinediones (glitazones) this period should not be less than 8 weeks.
  • Taking insulin whose daily dose on one occasion in the past 4 weeks has been more than 10% above or below their mean dose in the preceding 4 weeks.
  • Note: If a diabetic patient meets one of these criteria the patient is to be excluded even if the treating physician believes the patient is stable and can participate in the study.
  • An absolute neutrophil count (ANC) of <1.5 x 109/L
  • Inability to accommodate the visit schedule.
  • History of non-compliance as judged by the Principal Investigator.
  • Previous enrolment in the present study.
  • Participation in another clinical study or compassionate use programme within 4 weeks of screening (Day -7 to 0).
  • Involvement in the planning and conduct of the study (applies to both AstraZeneca staff or staff at the study site).

Trial locations and contacts

36 sites in 4 countries.

36 sites in 4 countries

Canada29 sites
  • Research Site

    Belleville, Ontario

  • Research Site

    Brantford, Ontario

  • Research Site

    Calgary, Alberta

  • Research Site

    Chatham, Ontario

  • Research Site

    Claresholm, Alberta

  • Research Site

    Cornwall, Ontario

  • Research Site

    Gatineau, Quebec

  • Research Site

    Greater Sudbury, Ontario

  • Research Site

    Greenfield Park, Quebec

  • Research Site

    London, Ontario

  • Research Site

    Markham, Ontario

  • Research Site

    Miramichi, New Brunswick

  • Research Site

    Mississauga, Ontario

  • Research Site

    Montreal, Quebec

  • Research Site

    Newmarket, Ontario

  • Research Site

    Oakville, Ontario

  • Research Site

    Orléans, Ontario

  • Research Site

    Prince Albert, Saskatchewan

  • Research Site

    Québec, Quebec

  • Research Site

    Red Deer, Alberta

  • Research Site

    Rouyn-Noranda, Quebec

  • Research Site

    Saskatoon, Saskatchewan

  • Research Site

    St. John's, Newfoundland and Labrador

  • Research Site

    Sydney, Nova Scotia

  • Research Site

    Toronto, Ontario

  • Research Site

    Vancouver, British Columbia

  • Research Site

    Verdun, Quebec

  • Research Site

    Victoria, British Columbia

  • Research Site

    Windsor, Ontario

Other trials in Canada

Australia5 sites
  • Research Site

    Brisbane, Queensland

  • Research Site

    Dandenong, Victoria

  • Research Site

    Garran, Australian Capital Territory

  • Research Site

    Meadowbrook, Queensland

  • Research Site

    Newcastle, New South Wales

Other trials in Australia

Hong Kong1 site
  • Research Site

    Hong Kong

Other trials in Hong Kong

South Korea1 site
  • Research Site

    Seoul, Korea

Other trials in South Korea

About this study

Official title: A Multicentre, Open-label, Prospective Long-term Study Evaluating the Clinical Benefit and Effectiveness of SEROQUEL XR® (Quetiapine Fumarate Extended-Release Tablets) in Subjects With Schizophrenia

A Multicentre, Open-label, Prospective Long-term Study Evaluating the Clinical Benefit and Effectiveness of SEROQUEL XR® (Quetiapine Fumarate Extended-Release Tablets) in Subjects with Schizophrenia.

Conditions
Schizophrenia
Being tested
Quetiapine Fumarate Extended- Release
Keywords
Seroquel, schizophrenia, Extended Release
Medical subject headings
Schizophrenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Quetiapine Fumarate Extended- ReleaseDrug

    Also called Seroquel XR®

    Open-label seroquel XR tablets: On Day 1 Patients received 300 mg, on Day 2 600 mg, on Day 3 600-800 mg and between Day 4-168 400-800 mg Seroquel XR, according to clinical judgement of investigator. Dose changes were in 200 mg fixed doses. Investigational product (IP) was supplied in open label wallet blister cards and subjects were instructed to take the IP once daily in the evening.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Subjects With Improved Clinical Benefit From Assessment of Clinical Global Impression-Clinical Benefit (CGI-CB) Scale From Baseline to Week 24 or End of Study

    Proportional change in CGI-CB score The CGI-CB scale is used to evaluate investigator's global weighted impression of efficacy and interference of adverse events (AEs) from enrolment to every visit. The score ranges from 1 to 10. The lower the score the better the outcome, e.g.: a score of 1 means that there is marked therapeutic effect with no burden of AEs. A score of 10 signifies that the burden of AEs outweighs the therapeutic effect, or no therapeutic effect with high burden of AEs. A change score for each subject will be calculated by subtracting the baseline score from the visit score.

    Measured: Baseline to 24 weeks (or end of study)

Secondary outcomes (10)
  1. Change in Clinical Global Impression-Clinical Benefit (CGI-CB) Score

    Numerical change in CGI-CB score. The CGI-CB scale is used to evaluate investigator's global weighted impression of efficacy and interference of adverse events (AEs) from enrolment to every visit. The score ranges from 1 to 10. The lower the score the better the outcome, e.g.: a score of 1 means that there is marked therapeutic effect with no burden of AEs. A score of 10 signifies that the burden of AEs outweighs the therapeutic effect, or no therapeutic effect with high burden of AEs. A change score for each subject will be calculated by subtracting the baseline score from the visit score.

    Measured: Baseline to 24 weeks

  2. Change in Positive and Negative Syndrome Scale for Schizophrenia (PANSS) Total Score

    Change in PANSS total score which includes Positive, Negative and General psychopathology. The PANSS is a 30-item scale where each symptom is rated on a severity scale ranging from 1-7, where 1=absent, 7=extreme). Maximum total score: 210, minimum total score is 30. Seven items are referring to positive symptoms (P1-7), seven items to negative symptoms (N1-7) and 16 items to general psychopathology (G1-16). The assessment prior to start of treatment is considered the baseline assessment.

    Measured: Baseline to 24 weeks

  3. Change in Positive and Negative Syndrome Scale for Schizophrenia (PANSS) Positive Scale Score

    Change in positive subscale of PANSS. This subscale calculates the sum of the scores in PANSS items P1-P7. (1=absent symptoms, 7=extreme symptoms). Maximum total score: 49, minimum total score: 7.

    Measured: Baseline to 24 weeks

  4. Change in Positive and Negative Syndrome Scale for Schizophrenia (PANSS) Negative Scale Score

    Change in negative subscale of PANSS. This subscale calculates the sum of the scores in PANSS items N1-N7. (1=absent symptoms, 7=extreme symptoms). Maximum total score: 49, minimum total score: 7.

    Measured: Baseline to 24 weeks

  5. Change in Global Assessment Scale (GAS)

    Change in GAS score. The GAS is a 100-point single item scale that rates patient's functioning on a hypothetical continuum of mental health to mental illness. The scale values range from 1 to 100 (1=most impaired, 100=healthiest).

    Measured: Baseline to 24 weeks

  6. Change in Clinical Global Impression-Severity (CGI-S) Scale

    The CGI-S assesses severity of illness which is scored to rate the patient's current clinical state at start of treatment. The scores range from 1 to 7, where 1= normal, not at all ill, while a score of 7=among the most extremely ill of subjects. The change from start of treatment in the severity of illness is calculated by subtracting the score at start of treatment from the visit score. Alleviation of symptom severity will be indicated by a negative change score.

    Measured: Baseline to 24 weeks

  7. Change in Clinical Global Impression-Improvement (CGI-I) Scale

    Change in CGI-I scale. This scale is the second part of the CGI scale that is scored at Visit 3 to week 24 to observe the patient's change from start of treatment. The scores for the CGI-I subset ranges from 1 to 7 (1=very much improved, 7=very much worse and a score of 4 indicates no change.)

    Measured: Day 7 - week 24

  8. Change in Social and Occupational Functioning Assessment Scale (SOFAS)

    Change in SOFAS score. The SOFAS is a 100 point single item scale that rates functioning of a patient. The scale values range from 1=most impaired to 100=healthiest individual. The scale also includes a rating point of 0=missing information.

    Measured: Baseline to 24 weeks

  9. Change in Safety Measure: Simpson-Angus Scale (SAS)

    The Percentage of patients with change in Simpson-Angus Scale (SAS)was calculated. This is a 10 item scale that is rated on a five-point scale where 0=normal and 4=severe symptoms of Extrapyramidal symptoms (EPS) with a focus on parkinsonian symptoms of EPS.

    Measured: Baseline to 24 weeks

  10. Change in Barnes Akathisia Rating Scale (BARS)

    The Percentage of patients with change in BARS score was calculated. The BARS is a 4 item scale that is rating Extrapyramidal symptoms (EPS) on a 4-point scale for the first three questions and on a 6-point scale for the last question. 0=normal and a higher value represents more pronounced symptoms of EPS. BARS has a focus on the akathisia symptoms of EPS.

    Measured: Baseline to 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Mar 2008 (estimated)
  2. Study startMar 2008
  3. Primary completionJul 2010
  4. Study completionJul 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
331 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00640601
Sponsor's protocol ID
D1443L00025
Acronym
SPECTRUM
Status last verified
Jun 2012
First submitted
17 Mar 2008
Last updated
25 Jun 2012
Data monitoring committee
No

Publications

  • Chue P, Malla A, Bouchard RH, Lessard S, Ganesan S, Stip E, Johnson S, Chen E, Ahn YM, Kim YS, Robinson G, Schweikert C, Gendron A, Eriksson H; SPECTRUM XR Study Group. The long-term clinical benefit and effectiveness of switching to once-daily quetiapine extended release in patients with schizophrenia. Curr Med Res Opin. 2013 Mar;29(3):227-39. doi: 10.1185/03007995.2012.762903. Epub 2013 Jan 22.

    PubMed 23281876

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Quetiapine Fumarate Extended- Release in people with Schizophrenia, run by AstraZeneca at 36 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 32 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Jun 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 36 sites in Canada, Australia, Hong Kong, South Korea. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 22 Jun 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Subjects With Improved Clinical Benefit From Assessment of Clinical Global Impression-Clinical Benefit (CGI-CB) Scale From Baseline to Week 24 or End of Study (time frame: Baseline to 24 weeks (or end of study)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00640601, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Jun 2012.

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