A Clinical Pharmacology Study of JNS010 (Paliperidone Palmitate) in Patients With Schizophrenia

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the pharmacokinetics (study of what the body does to a drug) and safety of paliperidone palmitate ranging from 75 to 150 milligram equivalents in repeated doses (4 injections) administered in the deltoid muscle (muscle in the shoulder) or gluteal muscle (group of muscles present in the buttocks) in participants with schizophrenia.

Detailed Description
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This is a multicenter (study conducted at multiple sites), open label (all people know the identity of the intervention), randomized (the study medication is assigned by chance), parallel-group (each group of participants will be treated at the same time) study. Approximately, 60 participants will be enrolled in the study. This study will consist of a screening phase (maximum 14 days), an observation phase (92 days), and a follow-up phase (98 days). Participants will be randomly assigned to treatment group A, B, or C. During the observation phase, participants will receive injections of paliperidone palmitate of concentration ranging from 75 to 150 milligram equivalents in the deltoid muscle or gluteal muscle as applicable on Days 1, 8, 36, and 64 alternating between sides (left/right). Safety evaluations will include assessment of adverse events, clinical laboratory tests, electrocardiogram, vital signs, physical examination, injection site reaction, drug-induced extrapyramidal symptoms scale, and visual analog scale which will be evaluated throughout the study. The total study duration for each participant will be approximately 190 days.

Official Title
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Clinical Pharmacology Study of JNS010 (Paliperidone Palmitate) in Subjects With Schizophrenia

Conditions
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Schizophrenia

Intervention / Treatment
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* Drug: Paliperidone palmitate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria:- Participants had to have the capability to provide informed consent in writing to participate in the study Participants with a diagnosis of schizophrenia in accordance with the diagnostic criteria for Diagnostic and Statistical Manual of Mental Disorders -IV-TR (DSM-IV-TR) Participants whose psychiatric symptom is considered stable by the investigator/subinvestigator at the time of giving informed consent Participants with a Positive and Negative Syndrome Scale (PANSS) score of less than or equal to 4 (moderate) in the following 9 items at screening: delusion, conceptual disorganization, hallucinatory behavior, excitement, grandiosity, suspiciousness/persecution, hostility, uncooperativeness, poor impulse control Participants with an experience of taking a risperidone formulation or a paliperidone formulation by 8 days before the initial day (Day 1) of the study treatment Exclusion Criteria:- DSM-IV-TR diagnosis other than schizophrenia DSM-IV-TR diagnosis of substance-related disorders within 180 days before the date of screening At a risk of suicide or other-injurious behavior as considered by the investigator/subinvestigator , and participants with a history of suicide attempts Concurrent condition of Parkinson's disease (except for drug-induced extrapyramidal syndrome) - Concurrent condition or history of symptomatic cerebrovascular accident

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment A<br>Participants will receive 4 injections of paliperidone palmitate 150 milligram in the deltoid muscle on Days 1, 8, 36, and 64. | Drug: Paliperidone palmitate<br>* Participants will receive 4 injections of paliperidone palmitate of concentration ranging from 75 to 150 milligram equivalents in deltoid or gluteal muscle as randomized to treatment group A, B, or C on Days 1, 8, 36, and 64.<br>* Other names: JNS010;|
| Experimental: Treatment B<br>Participants will receive 4 injections of paliperidone palmitate 75 milligram in the deltoid muscle on Days 1, 8, 36, and 64. | Drug: Paliperidone palmitate<br>* Participants will receive 4 injections of paliperidone palmitate of concentration ranging from 75 to 150 milligram equivalents in deltoid or gluteal muscle as randomized to treatment group A, B, or C on Days 1, 8, 36, and 64.<br>* Other names: JNS010;|
| Experimental: Treatment C<br>Participants will receive 4 injections of paliperidone palmitate 75 milligram in the gluteal muscle on Days 1, 8, 36, and 64. | Drug: Paliperidone palmitate<br>* Participants will receive 4 injections of paliperidone palmitate of concentration ranging from 75 to 150 milligram equivalents in deltoid or gluteal muscle as randomized to treatment group A, B, or C on Days 1, 8, 36, and 64.<br>* Other names: JNS010;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Plasma concentration of unchanged drug (Paliperidone palmitate) |  | Days 1 to 190 | 
| Plasma concentration of active metabolite (paliperidone) |  | Days 1 to 190 | 
| Plasma concentration of enantiomer of paliperidone palmitate (R078543) |  | Days 1 to 190 | 
| Plasma concentration of enantiomer paliperidone palmitate (R078544) |  | Days 1 to 190 | 
| Maximum Observed Plasma Concentration (Cmax) of paliperidone palmitate | The Plasma Concentration (Cmax) is defined as maximum observed analyte concentration. | Days 1 to 190 | 
| Time to Reach Maximum Observed Plasma Concentration (Tmax) of paliperidone palmitate | The Tmax is defined as actual sampling time to reach maximum observed analyte concentration. | Days 1 to 190 | 
| Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) of paliperidone palmitate | The Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) is a measure of the plasma paliperidone concentration from time zero to end of dosing interval. It is used to characterize drug absorption. | Days 1 to 190 | 
| Number of participants with adverse events |  | Up to Day 190 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Positive and Negative Syndrome Scale for Schizophrenia (PANSS) | The PANSS is a medical scale that assesses various symptoms of schizophrenia. The symptoms are rated on a 7-point scale from 1 (absent) to 7 (extreme psychopathology). The total score is the sum of all 30 PANSS items, with a range of 30 (absent) to 210 (extreme ill). Higher scores indicate worsening. | Screening, Baseline (Day 1), Days 8, 36, 64, and 92 | 
| Change From Baseline in Clinical Global Impression Severity (CGI-S) Scale Score | The CGI-S rating scale is a 7 point global assessment that measures the clinician's impression of the severity of illness exhibited by a participant. A rating of 1 is equivalent to Normal, not at all ill and a rating of 7 is equivalent to Among the most extremely ill participants. Higher scores indicate worsening. | Screening, Baseline (Day 1), Days 8, 36, 64, and 92 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Schizophrenia, JNS010, Paliperidone Palmitate, Clinical Pharmacology