Comparison of Antipsychotics for Metabolic Problems in Schizophrenia or Schizoaffective Disorder

NCT ID: NCT00423878

Last Updated: 2016-11-02

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

215 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-01-31

Study Completion Date

2010-03-31

Brief Summary

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The study will compare the effectiveness of antipsychotic medications for patients with schizophrenia or schizoaffective disorder for whom a medication change may be indicated because of an increased risk of cardiovascular disease.

Detailed Description

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Metabolic abnormalities associated with cardiovascular morbidity and premature mortality are more common in patients with schizophrenia than in matched controls. Although there is some evidence that patients with schizophrenia have intrinsic abnormalities in lipid and carbohydrate metabolism, some antipsychotics (i.e., clozapine, olanzapine, quetiapine, and risperidone) are associated with increased rates of metabolic abnormalities that predispose patients to cardiovascular disease.

This is an investigator-initiated clinical trial that will be conducted at 30 research sites that are a part of the NIMH Schizophrenia Trials Network.

The aims of the study are to (1) determine the relative effects of switching to aripiprazole, versus continued treatment with olanzapine, quetiapine, or risperidone, on metabolic parameters associated with cardiovascular disease, and (2) to determine the effects of switching to aripiprazole versus continued treatment with olanzapine, quetiapine, or risperidone on the clinical stability of schizophrenic illness.

This study design is a multi-site, single-blind (rater) randomized controlled trial of 300 patients with schizophrenia or schizoaffective disorder comparing treatment with the following medications: olanzapine, quetiapine, risperidone, and aripiprazole. The study will enroll patients with schizophrenia or schizoaffective disorder for whom a medication change may be indicated because of an increased risk of cardiovascular disease in spite of adequate control of symptoms on their current antipsychotic medication. Patients who are taking olanzapine, quetiapine, or risperidone and who have a body-mass index (BMI) greater than or equal to 27 and non-HDL cholesterol greater than or equal to 130 mg/dl will be eligible (if non-HDL is between 130-139mg/dL, LDL cholesterol must be greater than 100mg/dL). All treatments will be open label. Raters will be blinded to treatment assignment. Patients will be followed for up to 6 months.

Conditions

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Schizophrenia Schizoaffective Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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1

Participants will switch to aripiprazole with a cross-titration from the current antipsychotic over 3-4 weeks. Allowed final dosage range for aripiprazole was 5-30 mg/day

Group Type EXPERIMENTAL

Aripiprazole

Intervention Type DRUG

Switching medication to aripiprazole for schizophrenia for up to 6 months in study

2

Participants will continue with their current antipsychotic treatment, either olanzapine 5-20 mg/day, quetiapine 200-1200 mg/day, or risperidone 1-16 mg/day.

Group Type ACTIVE_COMPARATOR

Risperidone

Intervention Type DRUG

Continued treatment with the medication risperidone for schizophrenia for up to 6 months in study

Olanzapine

Intervention Type DRUG

Continued treatment with the medication olanzapine for schizophrenia for up to 6 months in study

Quetiapine

Intervention Type DRUG

Continued treatment with the medication quetiapine for schizophrenia for up to 6 months in study

Interventions

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Risperidone

Continued treatment with the medication risperidone for schizophrenia for up to 6 months in study

Intervention Type DRUG

Olanzapine

Continued treatment with the medication olanzapine for schizophrenia for up to 6 months in study

Intervention Type DRUG

Quetiapine

Continued treatment with the medication quetiapine for schizophrenia for up to 6 months in study

Intervention Type DRUG

Aripiprazole

Switching medication to aripiprazole for schizophrenia for up to 6 months in study

Intervention Type DRUG

Other Intervention Names

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Risperdal Zyprexa Seroquel Abilify

Eligibility Criteria

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Inclusion Criteria

* Diagnosed with schizophrenia or schizoaffective disorder
* Currently treated with olanzapine, quetiapine or risperidone
* BMI greater than or equal to 27
* Non-HDL cholesterol greater than or equal to 130 mg/dL (if non-HDL cholesterol is between 130 - 139 mg/dL, then LDL cholesterol must be greater than 100 mg/dL).

Exclusion Criteria

* Diabetes (FBS greater than or equal to 126) or treatment with oral hypoglycemic drug or insulin
* Non-HDL cholesterol greater than 300 mg/dL
* Serum triglycerides greater than 500 mg/dL
* Patients in the first episode of schizophrenia or schizoaffective disorder
* Known hypersensitivity to aripiprazole
* On weight loss medications
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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T. Scott Stroup, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Joseph P. McEvoy, MD

Role: STUDY_DIRECTOR

Duke University

Locations

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SHANTI Clinical Trials

Colton, California, United States

Site Status

Stanford University

Palo Alto, California, United States

Site Status

Yale University

New Haven, Connecticut, United States

Site Status

Mental Health Advocates

Boca Raton, Florida, United States

Site Status

University of Miami School of Medicine

Miami, Florida, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Medical College of Georgia

Augusta, Georgia, United States

Site Status

University of Iowa

Iowa City, Iowa, United States

Site Status

Clinical Research Institute

Wichita, Kansas, United States

Site Status

Lousiana State University Health Sciences Center

Shreveport, Louisiana, United States

Site Status

Clinical Insights

Glen Burnie, Maryland, United States

Site Status

Freedom Trail Clinic

Boston, Massachusetts, United States

Site Status

John C Corrigan Community Mental Health Center

Fall River, Massachusetts, United States

Site Status

University of Massachusetts

Worcester, Massachusetts, United States

Site Status

Wayne State University

Detroit, Michigan, United States

Site Status

University of Minnesota

Minneapolis, Minnesota, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

New Mexico VA Healthcare System

Albuquerque, New Mexico, United States

Site Status

Research Foundation for Mental Hygiene

New York, New York, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

John Umstead Hospital/Duke University

Butner, North Carolina, United States

Site Status

The University of North Carolina

Chapel Hill, North Carolina, United States

Site Status

Carolinas HealthCare System

Charlotte, North Carolina, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

Philadelphia VA Medical Center-116A

Philadelphia, Pennsylvania, United States

Site Status

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status

Countries

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United States

References

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Stroup TS, McEvoy JP, Ring KD, Hamer RH, LaVange LM, Swartz MS, Rosenheck RA, Perkins DO, Nussbaum AM, Lieberman JA; Schizophrenia Trials Network. A randomized trial examining the effectiveness of switching from olanzapine, quetiapine, or risperidone to aripiprazole to reduce metabolic risk: comparison of antipsychotics for metabolic problems (CAMP). Am J Psychiatry. 2011 Sep;168(9):947-56. doi: 10.1176/appi.ajp.2011.10111609. Epub 2011 Jul 18.

Reference Type BACKGROUND
PMID: 21768610 (View on PubMed)

Other Identifiers

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DSIR AT-AP

Identifier Type: OTHER

Identifier Source: secondary_id

STROUP06STN0

Identifier Type: -

Identifier Source: org_study_id