Trial Outcomes & Findings for A Trial to Explore Acceptance and Performance of Using a Digital Medicine System With Healthcare Professionals and Adults With Schizophrenia, Schizoaffective Disorder, or First Episode Psychosis on an Oral Atypical Antipsychotic (NCT NCT03568500)

NCT ID: NCT03568500

Last Updated: 2020-07-16

Results Overview

The DMS includes a drug-device combination of a CoE product, a wearable sensor patch, and application software (smartphone) to record activity and rest and mark events through the act of ingestion. The CoE product consists of an approved antipsychotic medication enclosed with an Ingestible Sensor Pill (miniature ingestible event marker in tablet \[MIT\]). The sensor patch detects and records each MIT ingestion, as well as other physiologic and behavioral data. Good patch coverage for a specific day was defined as having either at least 80% patch data available (80% of the day the patch was worn and data was collected as noted via the accelerometer channel) or the MIT was detected within the 24-hour period, for each day while the participant was in the trial. The percentage of days was calculated as the number of days with good patch coverage divided by the total number of trial days for each participant. Descriptive statistics were performed for this outcome measure.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

44 participants

Primary outcome timeframe

Up to 8 weeks

Results posted on

2020-07-16

Participant Flow

The trial enrolled participants with a confirmed clinical diagnosis of schizophrenia, schizoaffective disorder, or first episode psychosis.

Participants in this trial received at least 1 CoEncapsulated miniature ingestible event marker in a tablet and a medicinal product originator tablet of either aripiprazole, olanzapine, or quetiapine (participants were allowed to take risperidone, though no participant took risperidone in this trial) as prescribed by their healthcare professional.

Participant milestones

Participant milestones
Measure
Aripiprazole
Participants were treated with at least 1 CoEncapsulated (CoE) oral aripiprazole tablet, wearing the digital medicine system (DMS) patch, and using the associated smartphone app for a total of 8 weeks.
Olanzapine
Participants were treated with at least 1 CoE oral olanzapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Quetiapine
Participants were treated with at least 1 CoE oral quetiapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Overall Study
STARTED
18
20
6
Overall Study
Received At Least 1 Dose of Study Drug
18
19
6
Overall Study
COMPLETED
8
14
2
Overall Study
NOT COMPLETED
10
6
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Aripiprazole
Participants were treated with at least 1 CoEncapsulated (CoE) oral aripiprazole tablet, wearing the digital medicine system (DMS) patch, and using the associated smartphone app for a total of 8 weeks.
Olanzapine
Participants were treated with at least 1 CoE oral olanzapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Quetiapine
Participants were treated with at least 1 CoE oral quetiapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Overall Study
Lost to Follow-up
1
1
2
Overall Study
Adverse Event
1
1
2
Overall Study
Physician Decision
1
0
0
Overall Study
Withdrawal by Subject
4
2
0
Overall Study
Technical Problems
2
1
0
Overall Study
Participant Noncompliance
1
1
0

Baseline Characteristics

A Trial to Explore Acceptance and Performance of Using a Digital Medicine System With Healthcare Professionals and Adults With Schizophrenia, Schizoaffective Disorder, or First Episode Psychosis on an Oral Atypical Antipsychotic

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Aripiprazole
n=18 Participants
Participants were treated with at least 1 CoEncapsulated (CoE) oral aripiprazole tablet, wearing the digital medicine system (DMS) patch, and using the associated smartphone app for a total of 8 weeks.
Olanzapine
n=20 Participants
Participants were treated with at least 1 CoE oral olanzapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Quetiapine
n=6 Participants
Participants were treated with at least 1 CoE oral quetiapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Total
n=44 Participants
Total of all reporting groups
Age, Continuous
31.6 Years
STANDARD_DEVIATION 9.6 • n=5 Participants
38.0 Years
STANDARD_DEVIATION 11.4 • n=7 Participants
30.8 Years
STANDARD_DEVIATION 8.8 • n=5 Participants
34.4 Years
STANDARD_DEVIATION 10.7 • n=4 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
4 Participants
n=7 Participants
3 Participants
n=5 Participants
15 Participants
n=4 Participants
Sex: Female, Male
Male
10 Participants
n=5 Participants
16 Participants
n=7 Participants
3 Participants
n=5 Participants
29 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
17 Participants
n=5 Participants
18 Participants
n=7 Participants
5 Participants
n=5 Participants
40 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
2 Participants
n=7 Participants
1 Participants
n=5 Participants
4 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
4 Participants
n=5 Participants
4 Participants
n=7 Participants
0 Participants
n=5 Participants
8 Participants
n=4 Participants
Race (NIH/OMB)
White
14 Participants
n=5 Participants
15 Participants
n=7 Participants
6 Participants
n=5 Participants
35 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Disease Diagnosis
Schizophrenia
5 Participants
n=5 Participants
13 Participants
n=7 Participants
0 Participants
n=5 Participants
18 Participants
n=4 Participants
Disease Diagnosis
Schizoaffective Disorder
4 Participants
n=5 Participants
4 Participants
n=7 Participants
2 Participants
n=5 Participants
10 Participants
n=4 Participants
Disease Diagnosis
First Episode Psychosis
9 Participants
n=5 Participants
3 Participants
n=7 Participants
4 Participants
n=5 Participants
16 Participants
n=4 Participants

PRIMARY outcome

Timeframe: Up to 8 weeks

Population: Intent-to-treat (ITT) Population: All participants who entered the trial and used the DMS.

The DMS includes a drug-device combination of a CoE product, a wearable sensor patch, and application software (smartphone) to record activity and rest and mark events through the act of ingestion. The CoE product consists of an approved antipsychotic medication enclosed with an Ingestible Sensor Pill (miniature ingestible event marker in tablet \[MIT\]). The sensor patch detects and records each MIT ingestion, as well as other physiologic and behavioral data. Good patch coverage for a specific day was defined as having either at least 80% patch data available (80% of the day the patch was worn and data was collected as noted via the accelerometer channel) or the MIT was detected within the 24-hour period, for each day while the participant was in the trial. The percentage of days was calculated as the number of days with good patch coverage divided by the total number of trial days for each participant. Descriptive statistics were performed for this outcome measure.

Outcome measures

Outcome measures
Measure
Schizophrenia
n=18 Participants
Participants had a confirmed clinical diagnosis of schizophrenia (defined by International Classification of Disease-10 codes F20 and F25). There was no limit on the duration of illness. Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
Schizoaffective Disorder
n=9 Participants
Participants had a confirmed clinical diagnosis of schizoaffective disorder (defined by International Classification of Disease-10 codes F20 and F25). There was no limit on the duration of illness. Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
First Episode Psychosis
n=16 Participants
Participants had a confirmed clinical diagnosis of first episode psychosis using case note review. The duration of illness was defined as less than 3 years since presentation to the mental health team or first antipsychotic prescription. Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
Total
n=43 Participants
Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
Percentage Of Days With Good Patch Coverage
64.34 percentage of days
Standard Deviation 20.24
62.99 percentage of days
Standard Deviation 37.68
62.51 percentage of days
Standard Deviation 27.53
63.37 percentage of days
Standard Deviation 26.60

SECONDARY outcome

Timeframe: Up to 8 weeks

Population: Intent-to-treat (ITT) Population: All participants who entered the trial, used the DMS, and had data available at the specified timepoint.

The DMS includes a drug-device combination of a CoE product, a wearable sensor patch, and application software (smartphone) to record activity and rest and mark events through the act of ingestion. The CoE product consists of an approved antipsychotic medication enclosed with an Ingestible Sensor Pill (MIT). The sensor patch detects and records each MIT ingestion, as well as other physiologic and behavioral data. Participant adherence was measured as the detected MITs over the expected MITs ingested during the trial days with good patch coverage. The more the participant successfully engaged in a number of processes across the 8-week trial, the greater the measured adherence. Descriptive statistics were performed for this outcome measure.

Outcome measures

Outcome measures
Measure
Schizophrenia
n=18 Participants
Participants had a confirmed clinical diagnosis of schizophrenia (defined by International Classification of Disease-10 codes F20 and F25). There was no limit on the duration of illness. Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
Schizoaffective Disorder
n=8 Participants
Participants had a confirmed clinical diagnosis of schizoaffective disorder (defined by International Classification of Disease-10 codes F20 and F25). There was no limit on the duration of illness. Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
First Episode Psychosis
n=16 Participants
Participants had a confirmed clinical diagnosis of first episode psychosis using case note review. The duration of illness was defined as less than 3 years since presentation to the mental health team or first antipsychotic prescription. Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
Total
n=42 Participants
Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
Participant Adherence
88.94 percentage of MITs
Standard Deviation 8.06
72.29 percentage of MITs
Standard Deviation 25.65
91.04 percentage of MITs
Standard Deviation 7.37
86.57 percentage of MITs
Standard Deviation 14.47

Adverse Events

Aripiprazole

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

Olanzapine

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Quetiapine

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Total

Serious events: 0 serious events
Other events: 9 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Aripiprazole
n=18 participants at risk
Participants were treated with at least 1 CoEncapsulated (CoE) oral aripiprazole tablet, wearing the digital medicine system (DMS) patch, and using the associated smartphone app for a total of 8 weeks.
Olanzapine
n=19 participants at risk
Participants were treated with at least 1 CoE oral olanzapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Quetiapine
n=6 participants at risk
Participants were treated with at least 1 CoE oral quetiapine tablet, wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks.
Total
n=43 participants at risk
Participants were treated with at least 1 CoE oral atypical antipsychotic tablet (aripiprazole, olanzapine, or quetiapine), wearing the DMS patch, and using the associated smartphone app for a total of 8 weeks. The treatment medication decision was determined by the healthcare professional.
General disorders
Medical device site irritation
22.2%
4/18 • Number of events 5 • Baseline to Week 24 (+ 7 days)
10.5%
2/19 • Number of events 2 • Baseline to Week 24 (+ 7 days)
50.0%
3/6 • Number of events 4 • Baseline to Week 24 (+ 7 days)
20.9%
9/43 • Number of events 11 • Baseline to Week 24 (+ 7 days)

Additional Information

Global Clinical Development

Otsuka Pharmaceutical Development & Commercialization, Inc.

Phone: 1-609-524-6788

Results disclosure agreements

  • Principal investigator is a sponsor employee Sponsor reserves the right to review results publications prior to public release and can delay such publications for a period greater than 60 days but no more than 120 days from the date that the publication is submitted to the Sponsor for review. Sponsor can require changes to the publication to protect Sponsor's intellectual property rights and/or confidential information and reserves the right to limit publication timing and scope of data published based on the number of study locations.
  • Publication restrictions are in place

Restriction type: OTHER