Relative Effectiveness of Schizophrenia Therapy Study

NCT ID: NCT01245348

Last Updated: 2013-02-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1110 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-12-31

Study Completion Date

2012-12-31

Brief Summary

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The purpose of this study is to validate that SULT4A1-1 status stratification improves responses to atypical antipsychotics in schizophrenia and to extend these findings into bipolar disorder.

Detailed Description

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The total economic burden for schizophrenia (SZ) in the U.S. is estimated to be more than $60 billion annually. A large contributor to the economic burden of this and other chronic mental disorders, including bipolar disorder (BPD), is the exacerbation of symptoms and disability due to lack of drug efficacy. For these disorders, clinicians typically choose a first line antipsychotic therapy without the support of a diagnostic tool; often, patients are switched to another drug after less than six months of treatment due to what is perceived by patients and clinicians as both insufficient efficacy and unacceptable side effects.

Originally, the sulfotransferase family 4A, member 1 (SULT4A1) gene was selected as a biomarker of interest in SZ based on results showing associations between the gene and disease severity. Later on, SULT4A1 gene status was also associated with better efficacy of atypical antipsychotic (e.g. Zyprexa® (olanzapine) and Risperdal® (risperidone)), with respect to both time to discontinuation and quantitative measures of clinical improvement.

In this prospectively designed, non-randomized retrospective study, we will recruit and genotype subjects with schizophrenia or bipolar disorder that were/are new to therapy for any of the four drugs under evaluation. By looking at retrospective and prospective longitudinal medical and pharmacy data stored within the integrated claims database, we will validate the association of the SULT4A1 gene to the efficacy of selected atypical antipsychotic therapies.

Conditions

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Schizophrenia Bipolar Disorder

Study Groups

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Schizophrenia

Patient with schizophrenia

SULT4A1-1 genetic test

Intervention Type GENETIC

SULT4A1-1 haplotype result (+/-)

Bipolar

Patient with bipolar disorder

SULT4A1-1 genetic test

Intervention Type GENETIC

SULT4A1-1 haplotype result (+/-)

Interventions

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SULT4A1-1 genetic test

SULT4A1-1 haplotype result (+/-)

Intervention Type GENETIC

Eligibility Criteria

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Inclusion Criteria

* Subjects ≥ 18 years of age
* Subjects with either a confirmed diagnosis of schizophrenia or bipolar disorder or subjects with self reported schizophrenia or bipolar disorder
* Subjects who were/are new to therapy for olanzapine, risperidone, quetiapine or ziprasidone
* Subjects who are willing and able to provide informed consent

Exclusion Criteria

* Subjects initially prescribed less than the generally accepted minimally effective dose of the drugs under study
* Subjects with Major Depressive Disorder (MDD) or another psychotic disorder other than schizophrenia or bipolar disorder
* Subjects with catatonic schizophrenia
* Subjects with moderate to severe mental retardation
* Subjects that refuse to participate in the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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SureGene, LLC

INDUSTRY

Sponsor Role collaborator

Medco Health Solutions, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Kelly Parsons

Senior Research Manager

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kelly Parsons, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Medco Health Solutions, Inc.

Locations

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Medco Health Solutions, Inc.

Franklin Lakes, New Jersey, United States

Site Status

Countries

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United States

References

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Nasrallah HA. The case for long-acting antipsychotic agents in the post-CATIE era. Acta Psychiatr Scand. 2007 Apr;115(4):260-7. doi: 10.1111/j.1600-0447.2006.00982.x.

Reference Type BACKGROUND
PMID: 17355516 (View on PubMed)

Stroup TS, McEvoy JP, Swartz MS, Byerly MJ, Glick ID, Canive JM, McGee MF, Simpson GM, Stevens MC, Lieberman JA. The National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project: schizophrenia trial design and protocol development. Schizophr Bull. 2003;29(1):15-31. doi: 10.1093/oxfordjournals.schbul.a006986.

Reference Type BACKGROUND
PMID: 12908658 (View on PubMed)

Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK; Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005 Sep 22;353(12):1209-23. doi: 10.1056/NEJMoa051688. Epub 2005 Sep 19.

Reference Type BACKGROUND
PMID: 16172203 (View on PubMed)

Sullivan PF, Lin D, Tzeng JY, van den Oord E, Perkins D, Stroup TS, Wagner M, Lee S, Wright FA, Zou F, Liu W, Downing AM, Lieberman J, Close SL. Genomewide association for schizophrenia in the CATIE study: results of stage 1. Mol Psychiatry. 2008 Jun;13(6):570-84. doi: 10.1038/mp.2008.25. Epub 2008 Mar 18.

Reference Type BACKGROUND
PMID: 18347602 (View on PubMed)

Liyou NE, Buller KM, Tresillian MJ, Elvin CM, Scott HL, Dodd PR, Tannenberg AE, McManus ME. Localization of a brain sulfotransferase, SULT4A1, in the human and rat brain: an immunohistochemical study. J Histochem Cytochem. 2003 Dec;51(12):1655-64. doi: 10.1177/002215540305101209.

Reference Type BACKGROUND
PMID: 14623933 (View on PubMed)

Minchin RF, Lewis A, Mitchell D, Kadlubar FF, McManus ME. Sulfotransferase 4A1. Int J Biochem Cell Biol. 2008;40(12):2686-91. doi: 10.1016/j.biocel.2007.11.010. Epub 2007 Dec 3.

Reference Type BACKGROUND
PMID: 18248844 (View on PubMed)

Hildebrandt MA, Carrington DP, Thomae BA, Eckloff BW, Schaid DJ, Yee VC, Weinshilboum RM, Wieben ED. Genetic diversity and function in the human cytosolic sulfotransferases. Pharmacogenomics J. 2007 Apr;7(2):133-43. doi: 10.1038/sj.tpj.6500404. Epub 2006 Jun 27.

Reference Type BACKGROUND
PMID: 16801938 (View on PubMed)

Lewis AG, Minchin RF. Lack of exonic sulfotransferase 4A1 mutations in controls and schizophrenia cases. Psychiatr Genet. 2009 Feb;19(1):53-5. doi: 10.1097/YPG.0b013e3283118776.

Reference Type BACKGROUND
PMID: 19125109 (View on PubMed)

Brennan MD, Condra J. Transmission disequilibrium suggests a role for the sulfotransferase-4A1 gene in schizophrenia. Am J Med Genet B Neuropsychiatr Genet. 2005 Nov 5;139B(1):69-72. doi: 10.1002/ajmg.b.30222.

Reference Type BACKGROUND
PMID: 16152568 (View on PubMed)

Condra JA, Neibergs H, Wei W, Brennan MD. Evidence for two schizophrenia susceptibility genes on chromosome 22q13. Psychiatr Genet. 2007 Oct;17(5):292-8. doi: 10.1097/YPG.0b013e3281ac2345.

Reference Type BACKGROUND
PMID: 17728668 (View on PubMed)

Meltzer HY, Brennan MD, Woodward ND, Jayathilake K. Association of Sult4A1 SNPs with psychopathology and cognition in patients with schizophrenia or schizoaffective disorder. Schizophr Res. 2008 Dec;106(2-3):258-64. doi: 10.1016/j.schres.2008.08.029. Epub 2008 Sep 27.

Reference Type BACKGROUND
PMID: 18823757 (View on PubMed)

Leucht S, Arbter D, Engel RR, Kissling W, Davis JM. How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials. Mol Psychiatry. 2009 Apr;14(4):429-47. doi: 10.1038/sj.mp.4002136. Epub 2008 Jan 8.

Reference Type BACKGROUND
PMID: 18180760 (View on PubMed)

Wu EQ, Birnbaum HG, Shi L, Ball DE, Kessler RC, Moulis M, Aggarwal J. The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry. 2005 Sep;66(9):1122-9. doi: 10.4088/jcp.v66n0906.

Reference Type BACKGROUND
PMID: 16187769 (View on PubMed)

Ascher-Svanum H, Zhu B, Faries D, Landbloom R, Swartz M, Swanson J. Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia. BMC Psychiatry. 2006 Feb 21;6:8. doi: 10.1186/1471-244X-6-8.

Reference Type BACKGROUND
PMID: 16504026 (View on PubMed)

Other Identifiers

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REST

Identifier Type: -

Identifier Source: org_study_id

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