Study in Adolescents With Schizophrenia or Bipolar Disorder

Study Overview
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Brief Summary
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Open-label safety study of oral olanzapine treatment in adolescents, aged 13 to 17 years, with bipolar I disorder (manic or mixed episodes) or schizophrenia.

Official Title
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A Long-Term, Open-Label, Safety Study of Oral Olanzapine in Adolescents With Bipolar I Disorder (Manic or Mixed Episodes) or Schizophrenia

Conditions
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Bipolar I Disorder, Schizophrenia

Intervention / Treatment
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* Drug: Olanzapine
* Behavioral: Standard behavioral weight intervention
* Behavioral: Intense behavioral weight intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants must have a diagnosis of bipolar I disorder and display an acute manic or mixed episode (with or without psychotic features) or a diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision (DSM-IV-TR)and confirmed by the Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime (K-SADS-PL). Participants with a diagnosis of schizophrenia must obtain a Brief Psychiatric Rating Scale for Children (BPRS-C) total score >30, with a minimum score of 3 on at least one of the following items at both screening and randomization - hallucinations, delusions, peculiar fantasies. Participants with a diagnosis of bipolar I disorder must have a Young Mania Rating Scale (YMRS) total score greater than or equal to 15 at both screening and randomization. Has given assent (when applicable); and has a parent or authorized legal representative who has given informed consent, is reliable, has a level of understanding sufficient to permit participant to perform all tests and examinations required by the protocol, and understands the nature of the study. Exclusion Criteria: History of mental retardation, current comorbid autism, or current comorbid Pervasive Developmental Disorder. Have DSM-IV-TR substance (except nicotine and caffeine) dependence within the past 30 days prior to randomization. Been judged clinically to be at any suicidal risk. History of allergic reaction or hypersensitivity to olanzapine. Receiving current pharmaceutical treatment for weight management or are participating in a structured behavioral diet and/or exercise weight loss program. Other antipsychotics, mood stabilizers, or anticonvulsants (for mood stabilization) used for the primary study conditions (bipolar I disorder or schizophrenia) Have acute, serious, or unstable medical conditions Have any illness such that death is anticipated within 1 year or intensive care unit hospitalization for the illness is anticipated within 12 months (365 days). Have had one or more seizures without a clear and resolved etiology. Baseline alanine aminotransferase (ALT) values greater than or equal to 2 times the upper limit of normal (ULN) of the performing laboratory or aspartate aminotransferase (AST) values greater than or equal to 2 times the ULN or total bilirubin values greater than or equal to 1.5 times the ULN at screening. Have leukopenia or history of leukopenia without a clear and resolved etiology or known history of agranulocytosis (absolute neutrophil count <500 cubic millimeter [mm^3], <0.5 GI/L, or <0.5 10E^3/microliters [μL]) during the participant's lifetime. Prolactin level of >200 nanograms per milliliter (ng/mL) [>200 micrograms per liter (ug/L), or >4228 milli-International unit per liter (mIU/L)] at screening. Have QTc (Bazett's) >450 milliseconds (males) or >460 milliseconds (females) at screening. Previously been randomized in this study and/or participated in a clinical trial of another investigational drug, including olanzapine, within 1 month (30 days) prior to screening. Currently prescribed olanzapine for greater than or equal to 5 days within 1 month (30 days) prior to screening. Are investigator site personnel directly affiliated with this study and/or their immediate families OR are employed by or representatives of Lilly. Pregnant or nursing. Have received treatment within the last 30 days with an investigational new drug that has not received regulatory approval for any indication at the time of study entry. Treatment with clozapine within 14 days prior to randomization. Participants who have used olanzapine (that is, oral olanzapine, intramuscular [IM] olanzapine, or olanzapine orally disintegrating tablets) and have had treatment withdrawn due to clinically significant and/or intolerable adverse effects, or who have exhibited a lack of efficacy/response to treatment to olanzapine including treatment resistance.

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 17 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: Olanzapine/standard behavioral weight intervention<br> | Drug: Olanzapine<br>* 2.5 milligrams (mg) to 20 mg given orally, daily for 52 weeks<br>* Other names: LY170053;Behavioral: Standard behavioral weight intervention<br>* One time counseling and basic counseling information on healthy eating and exercise habits at randomization visit only.<br>|
| Experimental: Olanzapine/intense behavioral weight intervention<br> | Drug: Olanzapine<br>* 2.5 milligrams (mg) to 20 mg given orally, daily for 52 weeks<br>* Other names: LY170053;Behavioral: Intense behavioral weight intervention<br>* Counseling provided at randomization and at all subsequent study visits by appropriately trained individual regarding healthy lifestyle habits. Participants also provided with simple tools to help enable healthy eating and exercise habits.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Change From Baseline to 52 Weeks in Body Mass Index (BMI) for All Participants |  | Baseline, 52 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Change From Baseline to Endpoint in Body Mass Index (BMI) for Participants With Duration of Treatment of at Least 6 Months |  | Baseline, 52 weeks | 
| Time to Event for 7%, 15%, and 25% Weight Gain for All Participants | Kaplan-Meier methodology used to estimate time to event. Participants who never reached the target weight gain contributed to the set of patients at risk up to the point at which they discontinued from the study and were then censored (i.e., removed from the risk set). | Baseline up to 52 weeks | 
| Mean Change From Baseline to 52 Weeks in Adolescent Structured Young Mania Rating Scale (YMRS) for Participants With Bipolar I Disorder | The YMRS is an 11-item scale that measures the severity of manic episodes. Four items are rated on a scale from 0 (symptom not present) to 8 (symptom extremely severe). The remaining items are rated on a scale from 0 (symptom not present) to 4 (symptom extremely severe). The YMRS total score ranges from 0 (symptom not present) to 60 (symptom extremely severe). | Baseline, 52 weeks | 
| Mean Clinical Global Impression of Improvement (CGI-I) at 52 Weeks for All Participants | The Clinical Global Impression of Improvement (CGI-I) is used by the clinician to record the improvement of illness at the time of assessment. The score ranges from 1 (very much improved) to 7 (very much worse). | 52 weeks | 
| Mean Change From Baseline to 52 Weeks in Waist Circumference for All Participants |  | Baseline, 52 weeks | 
| Mean Change From Baseline to 52 Weeks in Clinical Global Impression - Severity (CGI-S) for All Participants | The CGI-S is used by the clinician to record the severity of illness at the time of assessment. The score ranges from 1 = normal, not at all ill to 7 = among the most extremely ill. | Baseline, 52 weeks | 
| Mean Change From Baseline to 52 Weeks in Anchored Version of the Brief Psychiatric Rating Scale for Children (BPRS-C) for Participants With Schizophrenia | The BPRS-C characterizes psychopathology. A total of 21 items are rated on a scale from 0 (not present) to 6 (extremely severe) with a total score ranging from 0 to 126. A decrease in score indicates a reduction in psychopathology. | Baseline, 52 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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safety, schizophrenia, bipolar I (manic or mixed), adolescents, weight management