A Comparison of Long-acting Injectable Medications for Schizophrenia

NCT ID: NCT01136772

Last Updated: 2016-10-21

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

311 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-03-31

Study Completion Date

2016-07-31

Brief Summary

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The purpose of this research study is to compare the "real-world" effectiveness of two FDA-approved and widely used long-acting injectable antipsychotic medications (paliperidone palmitate and haloperidol decanoate) in patients with schizophrenia or schizoaffective disorder who are expected to benefit from the improved medication compliance associated with injectable medications. The goal is to evaluate the effects of the medications on outcomes of importance to patients (relapse, symptoms, adverse effects, functioning) as well as policy makers (all of the above plus costs).

Detailed Description

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The purpose of this comparative effectiveness research study is to learn more about different medications called antipsychotics that are used to treat schizophrenia or schizoaffective disorder. Specifically, we are looking at long-acting medications that are given by injection every month, instead of being taken by mouth every day. In this multi-site study, we are comparing the risk and benefits of two FDA-approved long-acting injectable medications (paliperidone palmitate and haloperidol decanoate). Study participants with schizophrenia or schizoaffective disorder are expected to benefit from the improved medication schedule.

This study aims to enroll 360 individuals with schizophrenia or schizoaffective disorder for whom treatment with a long-acting injectable antipsychotic medication is likely to be helpful. Study participants will be randomly assigned to treatment with either paliperidone palmitate and haloperidol decanoate for up to 24 months. Participants will have an equal chance of being assigned to each medication, however participants will not know which medication they are taking.

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

TRIPLE

Participants Caregivers Investigators

Study Groups

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Paliperidone palmitate

Intramuscular injections of paliperidone palmitate 39-234 mg every month

Group Type EXPERIMENTAL

paliperidone palmitate

Intervention Type DRUG

Paliperidone palmitate injections, 39 mg - 234 mg once a month

Haloperidol decanoate

Intramuscular injections of haloperidol decanoate 25-200 mg every month

Group Type ACTIVE_COMPARATOR

haloperidol decanoate

Intervention Type DRUG

haloperidol decanoate injections, 25-200 mg once a month

Interventions

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haloperidol decanoate

haloperidol decanoate injections, 25-200 mg once a month

Intervention Type DRUG

paliperidone palmitate

Paliperidone palmitate injections, 39 mg - 234 mg once a month

Intervention Type DRUG

Other Intervention Names

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Haldol Invega Sustenna

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of schizophrenia or schizoaffective disorder as defined by DSM-IV-TR criteria
* Age 18-65 years
* Capacity to provide informed consent
* Patients who are likely to benefit from treatment with long-acting injectable paliperidone palmitate or haloperidol decanoate
* Women of child bearing potential must have a negative serum pregnancy test at the Screening Visit.

Exclusion Criteria

* Patients who are currently stable and doing well on an antipsychotic regimen
* Patients not expected to benefit from the study medications due to past experience with risperidone, paliperidone or haloperidol
* Patients with tardive dyskinesia that is moderate or severe
* Patients with any medical condition that, in the judgment of the investigator, might preclude safe completion of the study
* Women who are pregnant or breastfeeding
* Patients with mental retardation
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 collaborator

Duke University

OTHER

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role collaborator

New York State Psychiatric Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Scott Stroup, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Joseph P McEvoy, MD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

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VA Palo Alto Heathcare Systems

Palo Alto, California, United States

Site Status

Yale University/Connecticut Mental Health Center

New Haven, Connecticut, United States

Site Status

University of Miami School of Medicine

Miami, Florida, United States

Site Status

Medical College of Georgia

Augusta, Georgia, United States

Site Status

University of Iowa Hospital

Iowa City, Iowa, United States

Site Status

Clinical Research Institute

Wichita, Kansas, United States

Site Status

Clinical Insights, Inc.

Glen Burnie, Maryland, United States

Site Status

John D. Dingell VA Medical Center

Detroit, Michigan, United States

Site Status

Sparrow St. Lawrence Hospital, Michigan State University Psychiatry

Lansing, Michigan, United States

Site Status

Kansas City Veterans Affairs Medical Center

Kansas City, Missouri, United States

Site Status

Creighton University Dept. of Psychiatry

Omaha, Nebraska, 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

University of North Carolina

Chapel Hill, North Carolina, United States

Site Status

Carolina Behavioral Care

Durham, North Carolina, United States

Site Status

Louis Stokes Cleveland VA Medical Center

Brecksville, 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

Central Texas Veterans Health Care System

Waco, Texas, United States

Site Status

Frontier Institute

Spokane, Washington, United States

Site Status

VA Puget Sound Health Care System

Tacoma, Washington, United States

Site Status

Countries

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United States

References

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McEvoy JP, Byerly M, Hamer RM, Dominik R, Swartz MS, Rosenheck RA, Ray N, Lamberti JS, Buckley PF, Wilkins TM, Stroup TS. Effectiveness of paliperidone palmitate vs haloperidol decanoate for maintenance treatment of schizophrenia: a randomized clinical trial. JAMA. 2014 May 21;311(19):1978-87. doi: 10.1001/jama.2014.4310.

Reference Type RESULT
PMID: 24846035 (View on PubMed)

Rosenheck RA, Leslie DL, Sint KJ, Lin H, Li Y, McEvoy JP, Byerly MJ, Hamer RM, Swartz MS, Stroup TS. Cost-Effectiveness of Long-Acting Injectable Paliperidone Palmitate Versus Haloperidol Decanoate in Maintenance Treatment of Schizophrenia. Psychiatr Serv. 2016 Oct 1;67(10):1124-1130. doi: 10.1176/appi.ps.201500447. Epub 2016 Jun 1.

Reference Type RESULT
PMID: 27247177 (View on PubMed)

Stroup TS, Bareis NA, Rosenheck RA, Swartz MS, McEvoy JP. Heterogeneity of Treatment Effects of Long-Acting Injectable Antipsychotic Medications. J Clin Psychiatry. 2018 Nov 27;80(1):18m12109. doi: 10.4088/JCP.18m12109.

Reference Type DERIVED
PMID: 30549494 (View on PubMed)

Other Identifiers

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R01MH081107

Identifier Type: NIH

Identifier Source: secondary_id

View Link

#6017

Identifier Type: -

Identifier Source: org_study_id

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