Trial Outcomes & Findings for Tocilizumab as Add-On Treatment For Residual Positive, Negative, and Cognitive Symptoms of Schizophrenia (NCT NCT02034474)

NCT ID: NCT02034474

Last Updated: 2018-12-26

Results Overview

To evaluate an anticipated clinical response to tocilizumab treatment including positive, negative and cognitive symptoms by the change in the Positive and Negative Syndrome Scale (PANSS) total score. Score ranges from 30 to 210 for PANSS total, 16-112 for General, 7-49 for positive and 7-49 for negative symptoms subscales. A lower score means less symptomatic. There is a total score and general psychopathology scores, a positive symptoms score and a negative symptom score. The unit of measure is units on a scale from 1-7, whole numbers only. Summed scores are simply added to each other

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

59 participants

Primary outcome timeframe

Baseline (start of tocilizumab) through 12 weeks. We present the change scores

Results posted on

2018-12-26

Participant Flow

Of the 59 subjects who signed consent, 22 did not receive study drug. In addition, one of the 37 subjects who received study drug did not participate in any follow up assessments so was not included in the ITT analysis

Participant milestones

Participant milestones
Measure
Tocilizumab
Tocilizumab (N=19)
Placebo
Placebo (N=17)
Overall Study
STARTED
19
17
Overall Study
1 Dose
2
4
Overall Study
2 Doses
2
0
Overall Study
3 Doses
15
13
Overall Study
COMPLETED
15
13
Overall Study
NOT COMPLETED
4
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Tocilizumab
Tocilizumab (N=19)
Placebo
Placebo (N=17)
Overall Study
Adverse Event
3
2
Overall Study
Withdrawal by Subject
1
2

Baseline Characteristics

ITT population

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo
n=17 Participants
Placebo-receiving group
Tocilizumab
n=19 Participants
Tocilizumab-receiving group
Total
n=36 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=17 Participants • ITT population
0 Participants
n=19 Participants • ITT population
0 Participants
n=36 Participants • ITT population
Age, Categorical
Between 18 and 65 years
17 Participants
n=17 Participants • ITT population
19 Participants
n=19 Participants • ITT population
36 Participants
n=36 Participants • ITT population
Age, Categorical
>=65 years
0 Participants
n=17 Participants • ITT population
0 Participants
n=19 Participants • ITT population
0 Participants
n=36 Participants • ITT population
Age, Continuous
41.67 yrs
STANDARD_DEVIATION 10.25 • n=17 Participants • ITT Population
43.24 yrs
STANDARD_DEVIATION 11.42 • n=19 Participants • ITT Population
42.50 yrs
STANDARD_DEVIATION 10.76 • n=36 Participants • ITT Population
Sex: Female, Male
Female
4 Participants
n=17 Participants • ITT Population
7 Participants
n=19 Participants • ITT Population
11 Participants
n=36 Participants • ITT Population
Sex: Female, Male
Male
13 Participants
n=17 Participants • ITT Population
12 Participants
n=19 Participants • ITT Population
25 Participants
n=36 Participants • ITT Population
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=17 Participants • ITT Population
5 Participants
n=19 Participants • ITT Population
6 Participants
n=36 Participants • ITT Population
Ethnicity (NIH/OMB)
Not Hispanic or Latino
16 Participants
n=17 Participants • ITT Population
14 Participants
n=19 Participants • ITT Population
30 Participants
n=36 Participants • ITT Population
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=17 Participants • ITT Population
0 Participants
n=19 Participants • ITT Population
0 Participants
n=36 Participants • ITT Population
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=17 Participants • ITT Population
0 Participants
n=19 Participants • ITT Population
0 Participants
n=36 Participants • ITT Population
Race (NIH/OMB)
Asian
1 Participants
n=17 Participants • ITT Population
0 Participants
n=19 Participants • ITT Population
1 Participants
n=36 Participants • ITT Population
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=17 Participants • ITT Population
0 Participants
n=19 Participants • ITT Population
0 Participants
n=36 Participants • ITT Population
Race (NIH/OMB)
Black or African American
6 Participants
n=17 Participants • ITT Population
12 Participants
n=19 Participants • ITT Population
18 Participants
n=36 Participants • ITT Population
Race (NIH/OMB)
White
9 Participants
n=17 Participants • ITT Population
5 Participants
n=19 Participants • ITT Population
14 Participants
n=36 Participants • ITT Population
Race (NIH/OMB)
More than one race
1 Participants
n=17 Participants • ITT Population
2 Participants
n=19 Participants • ITT Population
3 Participants
n=36 Participants • ITT Population
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=17 Participants • ITT Population
0 Participants
n=19 Participants • ITT Population
0 Participants
n=36 Participants • ITT Population
Region of Enrollment
United States
17 Participants
n=17 Participants • ITT Population
19 Participants
n=19 Participants • ITT Population
36 Participants
n=36 Participants • ITT Population
PANSS Total
73.94 panss score
STANDARD_DEVIATION 15.52 • n=17 Participants
70.68 panss score
STANDARD_DEVIATION 11.2 • n=19 Participants
72.22 panss score
STANDARD_DEVIATION 14.24 • n=36 Participants
Smoker
7 Participants
n=17 Participants
8 Participants
n=19 Participants
15 Participants
n=36 Participants
cigs /day
8 cigarettes per day
STANDARD_DEVIATION 3 • n=17 Participants
10 cigarettes per day
STANDARD_DEVIATION 5 • n=19 Participants
9 cigarettes per day
STANDARD_DEVIATION 4 • n=36 Participants
chlorpromazine equivalents
377 milligrams
STANDARD_DEVIATION 346 • n=12 Participants • Some participants did not provide antipsychotic dosage information to be converted to chlorpromazine equivalent
257 milligrams
STANDARD_DEVIATION 192 • n=5 Participants • Some participants did not provide antipsychotic dosage information to be converted to chlorpromazine equivalent
310 milligrams
STANDARD_DEVIATION 396 • n=17 Participants • Some participants did not provide antipsychotic dosage information to be converted to chlorpromazine equivalent
weight
203.24 pounds
STANDARD_DEVIATION 51.95 • n=17 Participants
218.63 pounds
STANDARD_DEVIATION 45.24 • n=19 Participants
211.36 pounds
STANDARD_DEVIATION 44.01 • n=36 Participants
Clinical Global Impression - Severity Scale
4 units on a scale
STANDARD_DEVIATION 0.4 • n=17 Participants
4 units on a scale
STANDARD_DEVIATION 0.3 • n=19 Participants
4 units on a scale
STANDARD_DEVIATION 0.5 • n=36 Participants

PRIMARY outcome

Timeframe: Baseline (start of tocilizumab) through 12 weeks. We present the change scores

Population: 17 placebo patients and 19 tocilizumab patients were included in the ITT analysis

To evaluate an anticipated clinical response to tocilizumab treatment including positive, negative and cognitive symptoms by the change in the Positive and Negative Syndrome Scale (PANSS) total score. Score ranges from 30 to 210 for PANSS total, 16-112 for General, 7-49 for positive and 7-49 for negative symptoms subscales. A lower score means less symptomatic. There is a total score and general psychopathology scores, a positive symptoms score and a negative symptom score. The unit of measure is units on a scale from 1-7, whole numbers only. Summed scores are simply added to each other

Outcome measures

Outcome measures
Measure
Placebo
n=17 Participants
Patients on placebo
Tocilizumab
n=19 Participants
Patients on Tocilizumab
Clinical Response to Tocilizumab
-5.33 Units on a scale (PANSS)
Standard Deviation 17.96
-0.5 Units on a scale (PANSS)
Standard Deviation 12.62

SECONDARY outcome

Timeframe: Baseline (start of tocilizumab) through 12 weeks

Population: These subjects were included in the ITT analysis and received the MATRICS. We will present total composite change scores from baseline to week 12

MATRICS cognitive consensus battery, overall t score change. The composite T-score at each time point (baseline and week 12) is a T-Score (ranging from 0 to 100) reflecting overall neuropsychological function, aggregated from the participant's T-scores on the MATRICS subscales for Speed of Processing, Attention/Vigilance, Working Memory, Verbal Learning, Visual Learning, Reasoning and Problem Solving, and Social Cognition. The outcome is the difference between overall composite T-score at baseline and week 12, with higher difference score reflecting a greater improvement in neuropsychological performance.

Outcome measures

Outcome measures
Measure
Placebo
n=17 Participants
Patients on placebo
Tocilizumab
n=19 Participants
Patients on Tocilizumab
Cognitive Symptomatology - Overall MATRICS t Score Change
2.83 T Score Difference
Standard Deviation 5.59
1.47 T Score Difference
Standard Deviation 8.53

SECONDARY outcome

Timeframe: Baseline (start of tocilizumab) through 12 weeks

Population: These subjects were included in the ITT analysis and received the UPSA at both baseline and week 12.We will present total composite change scores from baseline to week 12

At Baseline and Week 12, participants are UPSA-B given items reflecting ability to complete tasks encountered in daily life, across two domains, Financial Skills and Communication Skills. % correct is calculated for each domain and converted to a standardized score from 0-50. These scores are summed to produce a total summary score ranging from 0-100. The outcome is the difference between this summary score at Baseline and Week 12, with a higher difference score reflecting a greater increase in functional capacity.

Outcome measures

Outcome measures
Measure
Placebo
n=16 Participants
Patients on placebo
Tocilizumab
n=12 Participants
Patients on Tocilizumab
Cognitive Symptomatology - UPSA-B Score Change
1.12 Change in score on a scale
Standard Deviation 0.23
1.12 Change in score on a scale
Standard Deviation 0.17

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline (start of tocilizumab) through 12 weeks

Comparison of cytokines, in particular IL-6 levels and the positive, negative and cognitive symptoms and impairments in daily functioning in schizophrenia. These outcomes will be measured by Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Clinical Global Impression (CGI), University of California Performance Skills Assessments (UPSA) and MATRICS.

Outcome measures

Outcome data not reported

Adverse Events

Placebo

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Tocilizumab

Serious events: 1 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Placebo
n=17 participants at risk
Subjects who received placebo
Tocilizumab
n=19 participants at risk
Subjects who received tocilizumab
Blood and lymphatic system disorders
agranulocytosis
0.00%
0/17 • 3 years
5.3%
1/19 • Number of events 1 • 3 years

Other adverse events

Other adverse events
Measure
Placebo
n=17 participants at risk
Subjects who received placebo
Tocilizumab
n=19 participants at risk
Subjects who received tocilizumab
Nervous system disorders
Inpatient admission
5.9%
1/17 • Number of events 1 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
Blood and lymphatic system disorders
Low ANC
11.8%
2/17 • Number of events 2 • 3 years
10.5%
2/19 • Number of events 2 • 3 years
Respiratory, thoracic and mediastinal disorders
URI
5.9%
1/17 • Number of events 1 • 3 years
0.00%
0/19 • 3 years
Infections and infestations
Tooth infection
5.9%
1/17 • Number of events 1 • 3 years
0.00%
0/19 • 3 years
Gastrointestinal disorders
nausea
0.00%
0/17 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
General disorders
fatigue
0.00%
0/17 • 3 years
5.3%
1/19 • Number of events 1 • 3 years

Additional Information

Ragy Girgis,MD

NYSPI

Phone: 6467745553

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place