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Bipolar Disorder ManiaPhase 3NCT00665366

Study to Evaluate the Efficacy and Safety of Aripiprazole Administered With Lithium or Valproate Over 12 Weeks in the Treatment of Mania in Bipolar I Disorder

A Phase 3 study testing Aripiprazole, Lithium and Valproate in people with Bipolar Disorder Mania, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 73 sites in 13 countries.

Completed

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

Official record
Search all trials

Trial summary

The purpose of the study is to determine whether aripiprazole provides additional clinical benefit to patients with Bipolar I disorder when combined with lithium or valproate over 12 weeks. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bipolar Disorder Mania
What is being tested?
Aripiprazole, Lithium and Valproate
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
493 participants
Where
73 sitesin 13 countries
Study dates
Jun 2008to Oct 2011
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Clinical diagnosis of bipolar I disorder mania, manic or mixed episode, with or without psychotic features
  • Current ongoing lithium or valproate treatment with the possibility of benefiting, based on the investigator's clinical judgment, from adjunctive treatment with aripiprazole
  • Therapeutic serum levels of lithium or valproate and a Young Mania Rating Total Score of 16 or higher at screening and baseline
  • Participants taking current lithium or valproate treatment combined with antipsychotic medication other than aripiprazole are acceptable, provided that the other antipsychotic medication is washed out at least 3 days prior to the blood draw for therapeutic plasma levels of lithium and valproate determination. Long-acting antipsychotics must be washed out prior to entering the double-blind treatment.

Who cannot join

  • Women of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 4 weeks after the last dose of investigational product
  • A diagnosis of delirium, dementia, amnesia or other cognitive disorder, or a psychotic disorder
  • Current diagnosis of delirium, dementia, a cognitive disorder (ie, amnesia), or a psychotic disorder (ie, schizophrenia or schizoaffective disorder)
  • Current diagnosis of bipolar II disorder, bipolar disorder not otherwise specified, or any other primary psychiatric disorder other than bipolar I disorder mania
  • Thyroid pathology
  • Demonstrated cocaine abuse or dependence within the past 3 months prior to screening.
Show all 10Show fewer
  • History of neuroleptic malignant syndrome from antipsychotic agents
  • Manic symptoms that investigator considers refractory to treatment
  • Previous nonresponsive (by investigator judgment) to aripiprazole for manic symptoms
  • Significant risk of suicide based on history, mental status exam, or investigator judgment.

Trial locations and contacts

73 sites in 13 countries.

73 sites in 13 countries

France15 sites
  • Local Institution

    Beaupuy, 31850

  • Local Institution

    Brumath, 67173

  • Local Institution

    Château-Gontier, 53200

  • Local Institution

    Clermont-Ferrand, 63001

  • Local Institution

    Dijon, 21000

  • Local Institution

    Dole, 39100

  • Local Institution

    Jonzac, 175003

  • Local Institution

    Le Vésinet, 78110

  • Local Institution

    Montpellier, 34295

  • Local Institution

    Nîmes, 30900

  • Local Institution

    Paris, 75116

  • Local Institution

    Reims, 51092

  • Local Institution

    Saint-Nazaire, 44606

  • Local Institution

    Sotteville-lès-Rouen, 76300

  • Local Institution

    Strasbourg, 67091

Other trials in France

Italy11 sites
  • Local Institution

    Campobasso, 86100

  • Local Institution

    Foggia, 71100

  • Local Institution

    Foligno (Pg), 06034

  • Local Institution

    Genova, 16132

  • Local Institution

    La Spezia, 19124

  • Local Institution

    Milan, 20121

  • Local Institution

    Naples, 80131

  • Local Institution

    Pisa, 56126

  • Local Institution

    Roma, 00168

  • Local Institution

    Roma, 00189

  • Local Institution

    Sant'Arsenio (Salerno), 84037

Other trials in Italy

Russia8 sites
  • Local Institution

    Khot'kovo, 141371

  • Local Institution

    Krasnodar, 350087

  • Local Institution

    Moscow, 115522

  • Local Institution

    Moscow, 119992

  • Local Institution

    Rostov-on-Don, 344010

  • Local Institution

    Saint Petersburg, 192019

  • Local Institution

    Samara, 443016

  • Local Institution

    Tomsk, 634014

Other trials in Russia

Hungary6 sites
  • Local Institution

    Budapest, 1083

  • Local Institution

    Budapest, 1097

  • Local Institution

    Budapest, 1125

  • Local Institution

    Budapest, 1135

  • Local Institution

    Győr, 9024

  • Local Institution

    Gyula, 5700

Other trials in Hungary

Poland6 sites
  • Local Institution

    Choroszcz, 16070

  • Local Institution

    Gdansk, 80-952

  • Local Institution

    Krakow, 30-393

  • Local Institution

    Krakow, 31-501

  • Local Institution

    Poznan, 60-572

  • Local Institution

    Swiecie N/Wisla, 86-100

Other trials in Poland

Czechia5 sites
  • Local Institution

    Hradec Králové, 500 05

  • Local Institution

    Litoměřice, 41201

  • Local Institution

    Prague, 101 00

  • Local Institution

    Prague, 120 00

  • Local Institution

    Prague, 160 00

Other trials in Czechia

South Africa5 sites
  • Local Institution

    Cape Town, Western Cape, 7530

  • Local Institution

    Johannesburg, Gauteng, 2198

  • Local Institution

    Pinetown, KwaZulu-Natal, 3600

  • Local Institution

    Soweto, Gauteng, 2001

  • Local Institution

    Vereeniging, Gauteng, 1939

Other trials in South Africa

Greece4 sites
  • Local Institution

    Athens, 151 26

  • Local Institution

    Leros, 85400

  • Local Institution

    Nea Ionia-Athens, 14233

  • Local Institution

    Tripoli, 22100

Other trials in Greece

Romania3 sites
  • Local Institution

    Bucharest, 041915

  • Local Institution

    Cluj-Nappoca, 400012

  • Local Institution

    Iași, 700282

Other trials in Romania

Spain3 sites
  • Local Institution

    Barcelona, 08036

  • Local Institution

    Madrid, 28046

  • Local Institution

    Murcia, 30120

Other trials in Spain

Turkey (Türkiye)3 sites
  • Local Institution

    Ankara, 06100

  • Local Institution

    Antalya, 07070

  • Local Institution

    Denizli, 20100

Other trials in Turkey (Türkiye)

Austria2 sites
  • Local Institution

    Salzburg, 5020

  • Local Institution

    Vienna, 1090

Other trials in Austria

Germany2 sites
  • Local Institution

    Ellwangen, 73479

  • Local Institution

    Ostfildern, 73760

Other trials in Germany

About this study

Official title: A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study To Evaluate the Efficacy and Safety of Adjunctive Aripiprazole Therapy in the Treatment of Mania in Bipolar I Disorder Patients Treated on Valproate or Lithium and in Need of Further Clinical Improvement

The purpose of the study is to determine whether aripiprazole provides additional clinical benefit to patients with Bipolar I disorder when combined with lithium or valproate over 12 weeks.

Being tested
Aripiprazole, Placebo, Lithium, Valproate

What participants receive

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

  • AripiprazoleDrug

    Also called Abilify, BMS-337039

    5-, 10-, or 15-mg oral tablets in titrated doses for 12 weeks

  • PlaceboDrug

    Tablets, Oral, 0 mg, once daily, 12 weeks

  • LithiumDrug

    Participant's ongoing dose

  • ValproateDrug

    Participant's ongoing dose

Study groups in NCT00665366
Study groupRoleWhat they receive
Placebo + valproate or lithiumPlacebo comparatorParticipants randomly received placebo (1:1 to study drug) as adjunctive therapy to current ongoing treatment with valproate or lithium for 12 weeks.
Receives: Drug: Placebo; Drug: Lithium; Drug: Valproate
Aripiprazole + valproate or lithiumActive comparatorParticipants randomly received aripiprazole as adjunctive therapy to current ongoing treatment with valproate or lithium for 12 weeks. Aripiprazole was provided in 5-, 10-, or 15-mg oral tablets and administered at a starting dose of 5 mg per day for Week 1. For Weeks 2 through 3, the dose was titrated up to 10 mg per day, and for Weeks 4 through 6, the dose increased to 15 mg per day. Flexible doses of either 15 or 30 mg per day were administered for Weeks 7 through 12. If participants were unable to tolerate the dose of 15 mg per day of study drug, the dose was decreased to 10 mg per day for Weeks 7 through 12.
Receives: Drug: Aripiprazole; Drug: Lithium; Drug: Valproate

What is being measured

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

  1. Change From Baseline in Total Score on the Young Mania Rating Scale (YMRS) (LOCF Data Set)

    The YMRS is a clinician-administered scale, consisting of 11 multiple choice items, and used to assess a patient's manic symptoms and clinical condition over the previous 48 hours. Total scores range from 0 to 60, with 12 or greater signifying hypomania or mania. Each item is given a severity rating ranging from 0 to 8 or 0 to 4. Items for the scale are based on the core symptoms of mania: elevated mood, increased motor activity, sexual interest, sleep, irritability, speech (rate and amount), language-though disorder, content, disruptive-aggressive behavior, appearance, and insight. Scores for each item reflect the severity of that symptom in the patient. The test is administered during a clinical interview typically lasting 15-30 minutes. LOCF=last observation carried forward.

    Measured: Baseline to Week 12

Secondary outcomes (11)
  1. Change From Baseline in Score on Clinical Global Impression-Bipolar Version (CGI-BP) Severity of Illness (Mania) Scale (LOCF Data Set)

    Adjusted mean change. The CGI-BP is a scale used to assess a clinician's impression of a patient's illness. Each patient is rated at baseline and at subsequent visits on items related to severity of depression, mania, and overall bipolar illness. The CGI-BP is a 7-point scale, with scores ranging from 1=normal/not ill to 7=very severely ill. Higher total score indicates greater severity of illness. LOCF=last observation carried forward.

    Measured: Baseline to Weeks 3, 6, 9, and 12

  2. Change From Baseline in Score on Clinical Global Impression-Bipolar Version (CGI-BP) Severity of Illness (Depression) Scale (LOCF Data Set)

    Adjusted mean change. The CGI-BP is a scale used to assess a clinician's impression of a patient's illness. Each patient is rated at baseline and at subsequent visits on items related to severity of depression, mania, and overall bipolar illness. The CGI-BP is a 7-point scale, with scores ranging from 1=normal/not ill to 7=very severely ill. Higher total score indicates greater severity of illness. LOCF=last observation carried forward.

    Measured: Baseline to Weeks 3, 6, 9, and 12

  3. Change From Baseline in Score on Clinical Global Impression-Bipolar Version (CGI-BP) Severity of Illness (Overall) Scale at Week 12 (LOCF Data Set)

    Adjusted mean change. The CGI-BP is scale used to assess a clinician's impression of a patient's illness. Each patient is rated at baseline and at subsequent visits on items related to severity of depression, mania, and overall bipolar illness. The CGI-BP is a 7-point scale, with scores ranging from 1=normal/not ill to 7=very severely ill. Higher total score indicates greater severity of illness. LOCF=last observation carried forward.

    Measured: Baseline to Week 12

  4. Change From Baseline in Total and Subscale Scores on the Functional Assessment Short Test (FAST)(LOCF Data Set)

    The FAST is an interview-administered instrument used to assess the main functioning problems that patients with bipolar disorder experience. Participants are rated at Baseline, Week 3, Week 6, Week 9, and Week 12/End of Study Visit. The FAST consists of 24 items that assess impairment or disability in 6 specific areas of functioning, categorized as the subscales: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal (IP) relationships, and leisure time. All items are rated using a 4-point scale, 0=no difficulty, 1=mild difficulty, 2=moderate difficulty, and 3=severe difficulty. The global score is the sum of the scores of all items and ranges from 0 (0*24)to 96 (4*24). The higher the global score, the higher the level of impairment. function=functioning. LOCF=last observation carried forward.

    Measured: Baseline to Weeks 3, 6, 9, and 12

  5. Percentage of Participants Showing A Response From Baseline on the Young Mania Rating Scale (YMRS)(OC Data Set)

    Response on the YMRS is defined as a 50% or greater improvement from baseline in YMRS total score. The YMRS is clinician-administered and consists of 11 multiple choice items. It is used to assess a patient's manic symptoms and clinical condition over the previous 48 hours. Total scores range from 0 to 60, with 12 or greater signifying hypomania or mania. Each item is given a severity rating ranging from 0 to 8 or 0 to 4. Items for the scale are based on the core symptoms of mania: elevated mood, increased motor activity, sexual interest, sleep, irritability, speech (rate and amount), language-thought disorder, content, disruptive-aggressive behavior, appearance, and insight. Scores for each item reflect the severity of that symptom in the patient. The test is administered during a clinical interview typically lasting 15-30 minutes. OC=observed cases.

    Measured: Baseline to Weeks 3, 6, 9, and 12

  6. Percentage of Participants Showing Remission in the Young Mania Rating Scale (YMRS) Score From Baseline (LOCF Data Set)

    Remission is defined as a YMRS total score of 12 or less. The YMRS is clinician-administered and consists of 11 multiple choice items. It is used to assess a patient's manic symptoms and clinical condition over the previous 48 hours. Total scores range from 0 to 60, with 12 or greater signifying hypomania or mania. Each item is given a severity rating ranging from 0 to 8 or 0 to 4. Items for the scale are based on the core symptoms of mania: elevated mood, increased motor activity, sexual interest, sleep, irritability, speech (rate and amount), language-thought disorder, disruptive-aggressive behavior, appearance, and insight. Scores for each item reflect the severity of that symptom in the patient. The test is administered during a clinical interview typically lasting 15-30 minutes. LOCF=last observation carried forward.

    Measured: Baseline to Weeks 3,6, 9, and 12

  7. Change From Baseline in Total Score on the Longitudinal Interval Follow-up Evaluation-Rating Impaired Functioning Tool (LIFE-RIFT)(OC Data Set and Week 12 LOCF Data Set)

    Adjusted mean change. The LIFE-RIFT total score ranges from 4 to 20 and is the sum of scores of 4 items: work, interpersonal relations, satisfaction, and recreation. A negative change score signifies improvement. OC=observed cases; LOCF=last observation carried forward.

    Measured: Baseline to Weeks 6 and 12

  8. Participant Scores on Patient Global Impression Improvement (PGI-I) Scale (OC Data Set)

    Adjusted Mean Scores. The PGI-I is a self-administered 7-point scale, with scores ranging from 1 (very much improved) to 7 (very much worse), that assesses the improvement or worsening of a patient's illness relative to baseline at the beginning of the intervention. Scores: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; or 7=very much worse. OC=observed cases.

    Measured: Baseline to Weeks 3, 6, 9, and 12

  9. Change From Baseline in Participant Weight (OC Data Set and Week 12 LOCF Data Set)

    Adjusted mean change.OC=observed cases; LOCF=last observation carried forward.

    Measured: Baseline to Weeks 3, 6, 9, and 12

  10. Percentage of Participants With Relevant Weight Gain or Weight Loss From Baseline at Week 12 (LOCF Data Set)

    Relevant weight gain=7% or greater increase in weight; relevant weight loss=7% or greater decrease in weight. LOCF=last observation carried forward.

    Measured: Baseline to Weeks 3, 6, 9, and12

  11. Change From Baseline to Week 12 in Body Mass Index (BMI) (LOCF Data Set)

    BMI=Weight in kilograms /(Height in meters^2). LOCF=last observation carried forward.

    Measured: Baseline to Week 12

Timeline

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

  1. First posted23 Apr 2008 (estimated)
  2. Study startJun 2008
  3. Primary completionOct 2011
  4. Study completionOct 2011

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
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
493 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00665366
Sponsor's protocol ID
CN138-502
Other IDs
EudraCT number 2007-005959-42
Status last verified
Feb 2013
First submitted
18 Apr 2008
Last updated
2 Dec 2013
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Aripiprazole, Lithium and Valproate in people with Bipolar Disorder Mania, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 73 sites in 13 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 4 inclusion and 10 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 2 Dec 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 73 sites in France, Italy, Russia, Hungary, Poland and 8 more countries. 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. Some participants in this study may receive a placebo. 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 4 Feb 2013). 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?

Change From Baseline in Total Score on the Young Mania Rating Scale (YMRS) (LOCF Data Set) (time frame: Baseline to Week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 2 Dec 2013.

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