Clinical trial NCT01731119: Study of Lurasidone in Treating Antipsychotic Naive or Quasi-Naive Children and Adolescents
Official title: An Open-Label Pilot Study of Lurasidone in Treating Antipsychotic Naive or Quasi-Naive Children and Adolescents
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Schizophrenia
Schizoaffective Disorder
Schizophreniform Disorder
Psychosis NOS
Autistic Disorder
Asperger Syndrome
Child Development Disorders, Pervasive
Bipolar I Disorder
Bipolar II Disorder
Mood Disorder NOS
Severe Major Depression With Psychotic Features
Single Episode Major Depression Without Psychotic Symptoms
Severe Mood Disorder With Psychotic Features
Keywords: Latuda,lurasidone,antipsychotics,autism, mood, psychosis
Lead sponsor: University of North Carolina, Chapel Hill
Sponsor class: OTHER
Collaborators: name: Foundation of Hope, North Carolina
First posted: 2012-11-21
Enrollment: 9
Sex: ALL
Minimum age (years): 6
Maximum age (years): 19
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The overarching purpose of this pilot study is to collect preliminary data regarding the variability of weight gain associated with lurasidone (Latuda©) treatment of antipsychotic naive children and adolescents in order to inform decisions about including a lurasidone arm in a future large scale trial of different approaches to minimize antipsychotic associated weight gain in the pediatric population. In adults, lurasidone appears to cause minimal weight gain. The participants will be 6-19 years old with psychotic spectrum, mood spectrum, or autism spectrum disorders. They will have 4 weeks or less of lifetime antipsychotic exposure.

Detailed description: This is a multi-site, 12-week, open-label study assessing the weight and metabolic changes associated with lurasidone treatment. Antipsychotic (AP) naive subjects will start open-label treatment by following a flexible titration schedule. Quasi-antipsychotic naive subjects (less than 4 weeks of total AP treatment) will be started on lurasidone and tapered off the other antipsychotic over an estimated 4 weeks depending on the dose and tolerability of the prior antipsychotic. Other psychoactive medications including antidepressants, benzodiazepines, stimulants, alpha-2 agonists, and mood stabilizers are allowed as long as the dose is not changed, unless it is clinically necessary. Assessments of weight, efficacy, and side effects are conducted at baseline, week 2, week 4, week 8, and week 12. The primary outcome is percent change in weight. The secondary outcomes include psychiatric efficacy measures and side effects.

Eligibility criteria: Inclusion Criteria:

* Male and female children and adolescents between 6 and 19 years of age of any race or ethnicity
* Subject must meet Diagnostic Statistical Manual (DSM)-IV-Text Revision (TR) criteria for a psychotic spectrum, mood spectrum or autism spectrum disorder as defined by one of the following diagnoses:

  * schizophrenia (any type)
  * schizoaffective disorder
  * schizophreniform disorder
  * psychosis Not Otherwise Specified (NOS)
  * autistic disorder with significant irritability/aggression (Aberrant Behavioral Checklist-Community (ABC-C) Irritability subscale score of greater than or equal to 18)
  * Asperger syndrome with significant irritability/aggression (ABC-C Irritability subscale score of greater than or equal to 18)
  * pervasive developmental disorder NOS with significant irritability/aggression (ABC-C Irritability subscale score of greater than or equal to 18)
  * bipolar type I
  * bipolar type II
  * mood disorder NOS
  * major depression with psychotic features
  * major depression (unresponsive to 2 different antidepressants)
  * severe mood dysregulation (SMD) according to Leibenluft and colleagues broad spectrum bipolar disorder
* Subjects must have ≤ 4 weeks of lifetime exposure to an antipsychotic medication at any dosage. These medications include olanzapine (Zyprexa©), quetiapine (Seroquel©), risperidone (Risperdal©), ziprasidone (Geodon©), aripiprazole (Abilify©), asenapine (Saphris©), iloperidone (Fanapt©), lurasidone (Latuda©), haloperidol, chlorpromazine, perphenazine, fluphenazine, thiothixene, or clozapine
* Subjects on other psychoactive medications are asked not to change dose of those medications during the course of the study unless clinically necessary
* Sexually active girls must agree to use two effective forms of birth control (i.e. hormonal or spermicidal and barrier) or be abstinent)
* Primary caretaker is able to participate in study appointments as is clinically indicated
* Ability of child to participate in all aspects of the protocol per investigator's clinical judgment
* After considering all aspects of study participation the subject (if an adult) or subject's parent or Legally Authorized Representative (LAR) must consent to participation
* After considering all aspects of study participation, the subject must assent to participation if it is developmentally appropriate to obtain assent

Exclusion Criteria:

* Based on current or lifetime DSM-IV-TR criteria, a diagnosis of Eating Disorder (Anorexia Nervosa or Bulimia Nervosa)
* Based on DSM-IV-TR criteria, a diagnosis of Substance Dependence Disorder (other than tobacco dependence) within the past month
* Treatment with the following concomitant medications: strong CYP3A4 inhibitors (ex: Ketoconazole), strong CYP3A4 inducers (ex: Rifampin)
* Current or past treatment with lurasidone (Latuda©) that resulted in a non-response or intolerance
* Females who are pregnant or breast-feeding
* Ongoing or previously undisclosed child abuse requiring new department of social service intervention
* Subjects who, in the Investigator's opinion, might not be suitable for the study

Primary outcomes:
measure: Change in Weight
timeFrame: Baseline to 12 weeks
Secondary outcomes:
measure: Proportion of Participants Completing Treatment
timeFrame: 12 weeks
measure: Changes in Efficacy Measures
timeFrame: Baseline to 12 weeks
measure: Number of Participants Experiencing Side Effects
timeFrame: Baseline to12 weeks
measure: Overall Clinical Improvement
timeFrame: Baseline to 12 weeks
Other outcomes:
Locations:
city: Chapel Hill
country: United States
facility: University of North Carolina
state: North Carolina
Study officials:
affiliation: University of North Carolina, Chapel Hill
name: Linmarie Sikich, MD
role: PRINCIPAL_INVESTIGATOR
References: