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SchizophreniaPhase 4NCT01929889

Assessing the Effects of Fanapt® on Social Cognition in Schizophrenia

A Phase 4 study testing Iloperidone in people with Schizophrenia and Schizoaffective Disorder, run by Northwestern University at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The study looks at whether treatment with iloperidone (Fanapt) is associated with improvements in social cognition in individuals who have been recently diagnosed with schizophrenia or schizoaffective disorder. Read more about this study

Who is it for?
Ages 18 to 55 years
Conditions the study is for
Schizophrenia, Schizoaffective Disorder
What is being tested?
Iloperidone
Could I receive a placebo?
No, everyone receives an active treatment
How many people
19 participants
Where
1 siteUnited States
Study dates
Apr 2012to Oct 2014
Phase
Phase 4
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 55 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Ability to give written informed consent
  • Male and female patients 18-55 years old
  • DSM-IV-TR diagnosis of schizophrenia or schizoaffective disorder.
  • Less than 5-year treatment history for schizophrenia or schizoaffective disorder.
  • Clinically stable for the last 2 weeks of the Fanapt® screening and stabilization phases.
  • Sufficiently stable overall health.
  • Women who can become pregnant must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 4 weeks after the study

Who cannot join

  • People unable to give informed consent
  • Baseline performance of 95% or higher on the cognitive empathy assessment
  • Pregnant and lactating women
  • A positive test for Hepatitis C antibody with concurrent evidence of impaired hepatic function
  • Subjects with a history of medical conditions which would pose a risk to the patient if they were to participate in the study or that might confound the results of the study
  • Known hypersensitivity to Fanapt® or any components in its formulation
Show all 13Show fewer
  • History of organic brain disorder
  • History of autism, pervasive developmental disability, mental retardation, or other cognitive disorder that could potentially confound cognitive testing
  • History of any medical condition that would confound the presentation or treatment of schizophrenia or schizoaffective disorder, or significantly increase the risk associated with the proposed treatment protocol
  • History of QTc prolongation, cardiac arrhythmias, or family history of sudden cardiac death
  • Patients taking strong inhibitors of CYP2D6 (fluoxetine, paroxetine, etc.) or CYP3A4 (ketoconazole, itraconazole, cimetidine, cyclosporine, etc.) or other medications that interact significantly with iloperidone
  • Patients who have met DSM-IV-TR criteria for current alcohol or substance dependence within the last six months or DSM-IV-TR criteria for alcohol or substance abuse within the last month
  • Patients regularly taking any medication that is known to interfere with performance on cognitive and social cognitive tasks, such as anticholinergics and benzodiazepines. Occasional benzodiazepine use may be permitted if subject can safely refrain from use for at least 24 hours prior to study visits.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Northwestern University

    Chicago, Illinois, 60611

Other trials in United States

About this study

Official title: An Exploratory Study to Assess the Effects of Fanapt® on Social Cognitive Performance

The study looks at whether treatment with iloperidone (Fanapt) is associated with improvements in social cognition in individuals who have been recently diagnosed with schizophrenia or schizoaffective disorder. Social cognition (the ability to understand your feelings and the feelings of others) is closely related to functional outcomes, including communication, empathy, and emotional recognition.

Read the detailed description

Schizophrenia is a disabling disease that affects about 1% of the population and is one of the leading causes of psychiatric disability. Striking early in life, schizophrenia interferes with work, relationships, and independence. Despite the billions of dollars spent annually in the direct and indirect costs of this disease, there are few treatment options that restore functionality. Lately, cognition has emerged as a target for interventions, since a patient's cognitive status is one of the most reliable predictors of functional outcome, and yet treatments for improving cognition have delivered only modest results. This study will attempt to evaluate the efficacy of Fanapt® (iloperidone) on social cognition, which consists of factors such as empathy, social perception, and emotional recognition, and may be more meaningfully tied to functional outcome than cognition in general.

This study will assess social cognition in people with schizophrenia or schizoaffective disorder who have newly begun taking Fanapt® (iloperidone), a new antipsychotic with mixed dopamine and serotonin antagonism. Standard measures of psychopathology and social cognition will be collected at baseline and then again at 12 weeks after becoming stable on the medication, by raters who are blind to the length of a subject's participation in the study. We predict that social cognition will improve with treatment with Fanapt®. This study has relatively few risks, including no risks beyond exposure to the study medication and the collection of safety data and psychometric data. The potential benefits outweigh the risks, with the main benefit being an ability to describe an improvement in cognitive performance that is believed to relate directly to real-world functional outcome.

Being tested
Iloperidone
Keywords
schizophrenia, schizoaffective disorder, iloperidone, Fanapt, social cognition, cognition
Medical subject headings
Schizophrenia, Psychotic Disorders

What participants receive

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

  • IloperidoneDrug

    Also called Fanapt

    Patients in this study will be treated with Fanapt® (iloperidone). They will begin a standardized up-titration starting with a dose of 2 mg daily. Dose increases will continue until the subject has achieved clinical stability, has achieved the maximum dose of 24 mg/day, or until 8 weeks have elapsed. Once clinical stability has been achieved, the patient will continue into the treatment phase. If clinical stability is not achieved after 8 weeks, the patient will be excluded from the study.

Study groups in NCT01929889
Study groupRoleWhat they receive
IloperidoneExperimentalPatients currently taking an antipsychotic medication other than Fanapt® will switch from their current medicine to Fanapt® in a cross-titration at a rate that is determined by the study physician. Treatment with iloperidone will be initiated and dosage will increase until the subject has achieved clinical stability, or has achieved the maximum dose, or 8 weeks have elapsed. Subjects who do not achieve clinical stability (as defined in the inclusion criteria) for the final 2 weeks in this 8-week period at the maximum dose of iloperidone will be discontinued from the study. If patients achieve stabilization, the lowest effective dose will be maintained. Subjects who have achieved clinical stability will then enter the 12-week treatment phase of the study.
Receives: Drug: Iloperidone

What is being measured

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

  1. Change in Social Cognition at 12 Weeks

    Facial Affect Perception Test that assesses the ability to accurately recognize facially expressed emotions as published by Smith et al 2014; Derntl et al., 2009. This scale ranges from 0-100 percent with a total of 30 trials. We examined the percent correct as the total number of correct responses divided by the total number of completed trials. There were no subscales. 100% accurate is the best outcome and 0% accurate is the worst outcome.

    Cognitive Empathy Test that assesses the ability to accurately determine the emotional expression of another person as depicted in a static image of a social interaction as published by Smith et al 2014; Derntl et al., 2009. This scale ranges from 0-100 percent with a total of 60 trials. We examined the percent correct as the total number of correct responses divided by the total number of completed trials. There were no subscales. 100% accurate is the best outcome and 0% accurate is the worst outcome.

    Measured: baseline and twelve weeks

Timeline

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

  1. First posted28 Aug 2013 (estimated)
  2. Study startApr 2012
  3. Primary completionFeb 2014
  4. Study completionOct 2014

Why it stopped: Low recruitment

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 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
19 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01929889
Sponsor's protocol ID
CIL0522DUS03T
Status last verified
Jun 2015
First submitted
19 Aug 2013
Last updated
10 Jul 2015
Data monitoring committee
No

Publications

  • Barch DM, Smith E. The cognitive neuroscience of working memory: relevance to CNTRICS and schizophrenia. Biol Psychiatry. 2008 Jul 1;64(1):11-7. doi: 10.1016/j.biopsych.2008.03.003. Epub 2008 Apr 8.

    PubMed 18400207
  • Bell M, Tsang HW, Greig TC, Bryson GJ. Neurocognition, social cognition, perceived social discomfort, and vocational outcomes in schizophrenia. Schizophr Bull. 2009 Jul;35(4):738-47. doi: 10.1093/schbul/sbm169. Epub 2008 Jan 31.

    PubMed 18245058
  • Bell MD, Zito W, Greig T, Wexler BE. Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. Schizophr Res. 2008 Oct;105(1-3):18-29. doi: 10.1016/j.schres.2008.06.026. Epub 2008 Aug 19.

    PubMed 18715755
  • Bellack AS, Schooler NR, Marder SR, Kane JM, Brown CH, Yang Y. Do clozapine and risperidone affect social competence and problem solving? Am J Psychiatry. 2004 Feb;161(2):364-7. doi: 10.1176/appi.ajp.161.2.364.

    PubMed 14754789
  • Brekke J, Kay DD, Lee KS, Green MF. Biosocial pathways to functional outcome in schizophrenia. Schizophr Res. 2005 Dec 15;80(2-3):213-25. doi: 10.1016/j.schres.2005.07.008. Epub 2005 Aug 30.

    PubMed 16137859
  • Brune M. Emotion recognition, 'theory of mind,' and social behavior in schizophrenia. Psychiatry Res. 2005 Feb 28;133(2-3):135-47. doi: 10.1016/j.psychres.2004.10.007.

    PubMed 15740990
  • Combs DR, Adams SD, Penn DL, Roberts D, Tiegreen J, Stem P. Social Cognition and Interaction Training (SCIT) for inpatients with schizophrenia spectrum disorders: preliminary findings. Schizophr Res. 2007 Mar;91(1-3):112-6. doi: 10.1016/j.schres.2006.12.010. Epub 2007 Feb 12.

    PubMed 17293083
  • Derntl B, Finkelmeyer A, Toygar TK, Hulsmann A, Schneider F, Falkenberg DI, Habel U. Generalized deficit in all core components of empathy in schizophrenia. Schizophr Res. 2009 Mar;108(1-3):197-206. doi: 10.1016/j.schres.2008.11.009. Epub 2008 Dec 16.

    PubMed 19087898
  • Glynn SM, Cohen AN, Dixon LB, Niv N. The potential impact of the recovery movement on family interventions for schizophrenia: opportunities and obstacles. Schizophr Bull. 2006 Jul;32(3):451-63. doi: 10.1093/schbul/sbj066. Epub 2006 Mar 8.

    PubMed 16525087
  • Harvey PD, Penn D. Social cognition: the key factor predicting social outcome in people with schizophrenia? Psychiatry (Edgmont). 2010 Feb;7(2):41-4.

    PubMed 20376275
  • Kane JM, Lauriello J, Laska E, Di Marino M, Wolfgang CD. Long-term efficacy and safety of iloperidone: results from 3 clinical trials for the treatment of schizophrenia. J Clin Psychopharmacol. 2008 Apr;28(2 Suppl 1):S29-35. doi: 10.1097/JCP.0b013e318169cca7.

    PubMed 18334910
  • Penn DL, Roberts DL, Combs D, Sterne A. Best practices: The development of the Social Cognition and Interaction Training program for schizophrenia spectrum disorders. Psychiatr Serv. 2007 Apr;58(4):449-51. doi: 10.1176/ps.2007.58.4.449.

    PubMed 17412842
  • Roberts DL, Penn DL, Labate D, Margolis SA, Sterne A. Transportability and feasibility of Social Cognition And Interaction Training (SCIT) in community settings. Behav Cogn Psychother. 2010 Jan;38(1):35-47. doi: 10.1017/S1352465809990464. Epub 2009 Oct 27.

    PubMed 19857363
  • Wolwer W, Frommann N, Halfmann S, Piaszek A, Streit M, Gaebel W. Remediation of impairments in facial affect recognition in schizophrenia: efficacy and specificity of a new training program. Schizophr Res. 2005 Dec 15;80(2-3):295-303. doi: 10.1016/j.schres.2005.07.018. Epub 2005 Aug 24.

    PubMed 16125367
  • Andreasen NC, Arndt S, Alliger R, Miller D, Flaum M. Symptoms of schizophrenia. Methods, meanings, and mechanisms. Arch Gen Psychiatry. 1995 May;52(5):341-51. doi: 10.1001/archpsyc.1995.03950170015003.

    PubMed 7726714

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Iloperidone in people with Schizophrenia and Schizoaffective Disorder, run by Northwestern University at 1 site in United States.

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 7 inclusion and 13 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: stopped early, as of the sponsor's last update on 10 Jul 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 10 Jul 2015). 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 in Social Cognition at 12 Weeks (time frame: baseline and twelve weeks). 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 NCT01929889, which also lists 15 linked publications.

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 10 Jul 2015.

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