Trial Outcomes & Findings for A Study to Assess the Safety and Efficacy of ASP4345 as Add-on Treatment for Cognitive Impairment in Subjects With Schizophrenia on Stable Doses of Antipsychotic Medication (NCT NCT03557931)
NCT ID: NCT03557931
Last Updated: 2024-11-12
Results Overview
The MCCB is a cognitive battery to assess 7 domains recommended by the MATRICS initiative (i.e., working memory, verbal learning, speed of processing, attention/vigilance, visual learning, social cognition, reasoning and problem solving). The MCCB neurocognitive composite score is a standardized mean of the six domain scores (excluding social cognition). Raw scores are converted to age and sex adjusted t-scores which are standardized to normative data, and have a mean of 50 and standard deviation of 10 in the general healthy population. A higher score indicates less impairment.
COMPLETED
PHASE2
233 participants
Baseline and week 12/end of treatment (EoT)
2024-11-12
Participant Flow
Participants who were 18 to 55 years of age (inclusive at screening) with stable schizophrenia or schizoaffective disorder with mild extrapyramidal symptoms on up to 2 antipsychotic therapies and who met inclusion criteria and none of the exclusion criteria were enrolled.
Participant milestones
| Measure |
Placebo
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 Milligrams (mg)
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Overall Study
STARTED
|
100
|
65
|
68
|
|
Overall Study
COMPLETED
|
69
|
46
|
55
|
|
Overall Study
NOT COMPLETED
|
31
|
19
|
13
|
Reasons for withdrawal
| Measure |
Placebo
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 Milligrams (mg)
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Overall Study
Adverse Event
|
4
|
6
|
1
|
|
Overall Study
Lost to Follow-up
|
4
|
4
|
1
|
|
Overall Study
Protocol Violation
|
1
|
4
|
1
|
|
Overall Study
Withdrawal by Subject
|
14
|
0
|
7
|
|
Overall Study
Miscellaneous
|
8
|
5
|
3
|
Baseline Characteristics
ITT population with available data at baseline.
Baseline characteristics by cohort
| Measure |
Placebo
n=100 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=65 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=68 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
Total
n=233 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
86 Participants
n=100 Participants
|
62 Participants
n=65 Participants
|
64 Participants
n=68 Participants
|
212 Participants
n=233 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=100 Participants
|
0 Participants
n=65 Participants
|
0 Participants
n=68 Participants
|
0 Participants
n=233 Participants
|
|
Age, Continuous
|
42.8 years
STANDARD_DEVIATION 9.1 • n=100 Participants
|
42.7 years
STANDARD_DEVIATION 9.2 • n=65 Participants
|
42.8 years
STANDARD_DEVIATION 9.9 • n=68 Participants
|
42.8 years
STANDARD_DEVIATION 9.3 • n=233 Participants
|
|
Sex: Female, Male
Female
|
27 Participants
n=100 Participants
|
23 Participants
n=65 Participants
|
20 Participants
n=68 Participants
|
70 Participants
n=233 Participants
|
|
Sex: Female, Male
Male
|
73 Participants
n=100 Participants
|
42 Participants
n=65 Participants
|
48 Participants
n=68 Participants
|
163 Participants
n=233 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
14 Participants
n=100 Participants
|
3 Participants
n=65 Participants
|
4 Participants
n=68 Participants
|
21 Participants
n=233 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
1 Participants
n=100 Participants
|
1 Participants
n=65 Participants
|
0 Participants
n=68 Participants
|
2 Participants
n=233 Participants
|
|
Race (NIH/OMB)
Asian
|
2 Participants
n=100 Participants
|
1 Participants
n=65 Participants
|
4 Participants
n=68 Participants
|
7 Participants
n=233 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=100 Participants
|
0 Participants
n=65 Participants
|
0 Participants
n=68 Participants
|
0 Participants
n=233 Participants
|
|
Race (NIH/OMB)
Black or African American
|
72 Participants
n=100 Participants
|
48 Participants
n=65 Participants
|
47 Participants
n=68 Participants
|
167 Participants
n=233 Participants
|
|
Race (NIH/OMB)
White
|
24 Participants
n=100 Participants
|
14 Participants
n=65 Participants
|
17 Participants
n=68 Participants
|
55 Participants
n=233 Participants
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=100 Participants
|
0 Participants
n=65 Participants
|
0 Participants
n=68 Participants
|
0 Participants
n=233 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
1 Participants
n=100 Participants
|
1 Participants
n=65 Participants
|
0 Participants
n=68 Participants
|
2 Participants
n=233 Participants
|
|
MATRICS Consensus Cognitive Battery (MCCB) Neurocognitive Composite Score
|
32.6 T-score
STANDARD_DEVIATION 13.3 • n=99 Participants • ITT population with available data at baseline.
|
34 T-score
STANDARD_DEVIATION 10.7 • n=65 Participants • ITT population with available data at baseline.
|
33.7 T-score
STANDARD_DEVIATION 12.3 • n=68 Participants • ITT population with available data at baseline.
|
33.3 T-score
STANDARD_DEVIATION 12.3 • n=232 Participants • ITT population with available data at baseline.
|
|
UPSA-2-ER Total Score
|
74.4 units on a scale
STANDARD_DEVIATION 16.7 • n=82 Participants • ITT population with available data at baseline.
|
80.2 units on a scale
STANDARD_DEVIATION 13.2 • n=59 Participants • ITT population with available data at baseline.
|
78.1 units on a scale
STANDARD_DEVIATION 15.5 • n=63 Participants • ITT population with available data at baseline.
|
77.2 units on a scale
STANDARD_DEVIATION 15.5 • n=204 Participants • ITT population with available data at baseline.
|
PRIMARY outcome
Timeframe: Baseline and week 12/end of treatment (EoT)Population: The full analysis set (FAS) consisted of all participants who were randomized and received at least 1 dose of study drug and had at least 1 postbaseline MCCB measurement. FAS population with available data at baseline and week12/EoT.
The MCCB is a cognitive battery to assess 7 domains recommended by the MATRICS initiative (i.e., working memory, verbal learning, speed of processing, attention/vigilance, visual learning, social cognition, reasoning and problem solving). The MCCB neurocognitive composite score is a standardized mean of the six domain scores (excluding social cognition). Raw scores are converted to age and sex adjusted t-scores which are standardized to normative data, and have a mean of 50 and standard deviation of 10 in the general healthy population. A higher score indicates less impairment.
Outcome measures
| Measure |
Placebo
n=67 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=45 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=51 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Change From Baseline to Week 12/End of Treatment (EoT) in Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) Neurocognitive Composite Score
|
1.15 T-score
Standard Error 0.65
|
1.34 T-score
Standard Error 0.79
|
0.87 T-score
Standard Error 0.75
|
PRIMARY outcome
Timeframe: Baseline up to end of study (EoS) (week 14)Population: The safety analysis set (SAF) consisted of all participants who took at least 1 dose of study drug.
Treatment emergent adverse event (TEAE) is defined as an AE observed after starting administration of the study drug and 28 days after the last dose of study drug. A study drug-related TEAE is defined as any TEAE with at least possible relationship to study treatment as assessed by the investigator or with missing assessment of the causal relationship. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product. Safety was assessed by AEs, which included abnormalities identified during a medical test (e.g. laboratory tests, vital signs, electrocardiogram, metabolic parameters etc.) if the abnormality induced clinical signs or symptoms, needed active intervention, interruption or discontinuation of study medication or was clinically significant.
Outcome measures
| Measure |
Placebo
n=100 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=65 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=68 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Number of Participants With Adverse Event (AE)
TEAE
|
45 participants
|
28 participants
|
28 participants
|
|
Number of Participants With Adverse Event (AE)
Drug-Related TEAEs
|
11 participants
|
13 participants
|
11 participants
|
|
Number of Participants With Adverse Event (AE)
Serious TEAEs
|
1 participants
|
3 participants
|
1 participants
|
|
Number of Participants With Adverse Event (AE)
Drug-Related Serious TEAE
|
0 participants
|
0 participants
|
0 participants
|
PRIMARY outcome
Timeframe: Baseline up to EoS (week 14)Population: SAF population
The C-SSRS is a questionnaire used for suicide risk assessment. Affirmative or negative responses are provided to items 1 to 5 for suicidal ideation (1. Wish to be dead, 2. Non-specific active suicidal thoughts, 3. Active suicidal ideation with any methods \[not plan\] without intent to act, 4. Active suicidal ideation with some intent to act, without specific plan, 5. Active suicidal ideation with specific plan and intent) and items 6 to 10 for suicide behavior (6. Preparatory acts or behavior, 7. Aborted attempt, 8. Interrupted attempt, 9. Actual attempt, 10. Completed suicide).
Outcome measures
| Measure |
Placebo
n=100 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=65 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=68 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Number of Participants With Clinically Significant Differences in Columbia-Suicide Severity Rating Scale (C-SSRS) Values
|
0 participants
|
0 participants
|
0 participants
|
PRIMARY outcome
Timeframe: Baseline, week 6 and week 12Population: SAF population with available data at each time point.
AIMS is a 14-item scale. Items 1 to 8 are rated on a 5-point scale ranging from 0 (no dyskinetic movements) to 4 (severe dyskinetic movements). Item 9 assesses the participant's incapacitation due to abnormal movements, and item 10 assesses the participant's awareness of the abnormal movements and associated distress. Items 9 and 10 are rated on 5-point scales ranging from 0 (none or no awareness) to 4 (severe or aware, severe distress). Items 11 to 14 are yes/no questions regarding the global judgement and dental status of the participant. The total score is the sum of the scores for the 14 items and the possible total score ranges from 0 to 44. A higher total score is indicative of more severe dyskinetic movements.
Outcome measures
| Measure |
Placebo
n=93 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=62 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=65 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Number of Participants With Clinically Significant Differences in Abnormal Involuntary Movement Scale (AIMS) Values
Baseline
|
0 participants
|
0 participants
|
0 participants
|
|
Number of Participants With Clinically Significant Differences in Abnormal Involuntary Movement Scale (AIMS) Values
Week 6
|
0 participants
|
0 participants
|
0 participants
|
|
Number of Participants With Clinically Significant Differences in Abnormal Involuntary Movement Scale (AIMS) Values
Week 12
|
0 participants
|
0 participants
|
0 participants
|
PRIMARY outcome
Timeframe: Baseline, week 6 and week 12Population: SAF population with available data at each time point.
SAS scale consists of 10 items including 7 items that address bradykinesia-rigidity and additional single items for tremor, glabellar tap, and salivation. Each item represents a specific physical condition and is rated on a 5-point category rating scale ranging from 0 (complete absence of the condition) to 4 (the condition is present to an extreme degree).The total score is obtained by adding the scores for the 10 individual items making the maximum possible score is 40. Higher scores are indicative of more severe Parkinsonian-type symptoms.
Outcome measures
| Measure |
Placebo
n=93 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=62 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=65 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Number of Participants With Clinically Significant Differences in Simpson Angus Scale (SAS) Values
Baseline
|
0 participants
|
0 participants
|
0 participants
|
|
Number of Participants With Clinically Significant Differences in Simpson Angus Scale (SAS) Values
Week 6
|
0 participants
|
0 participants
|
0 participants
|
|
Number of Participants With Clinically Significant Differences in Simpson Angus Scale (SAS) Values
Week 12
|
0 participants
|
0 participants
|
0 participants
|
PRIMARY outcome
Timeframe: Baseline, week 6 and week 12Population: SAF population with available data at each time point.
BARS is used to rate observable, restless movements of drug induced akathisia and subjective awareness of restlessness and any distress associated with the akathisia. BARS consists of the following 4 items: objective assessment of akathisia symptoms, subjective assessment of the participants's awareness of inner restlessness, distress restlessness, and global clinical assessment of akathisia. First three items are rated on a 4-point scale ranging from 0 (no abnormal movements or absence of inner restlessness or no distress) to 3 (severe akathisia or awareness of intense compulsion to move most of the time or severe distress). The last item, the global clinical assessment of akathisia, is rated on a 6-point scale, ranging from 0 (no evidence of akathisia) to 5 (severe akathisia). Total BARS score ranges from 0 to 14 with a higher score representing worse results.
Outcome measures
| Measure |
Placebo
n=93 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=62 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=66 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Number of Participants With Clinically Significant Differences in Barnes Akathisia Rating Scale (BARS) Values
Baseline
|
0 participants
|
0 participants
|
0 participants
|
|
Number of Participants With Clinically Significant Differences in Barnes Akathisia Rating Scale (BARS) Values
Week 6
|
0 participants
|
0 participants
|
0 participants
|
|
Number of Participants With Clinically Significant Differences in Barnes Akathisia Rating Scale (BARS) Values
Week 12
|
0 participants
|
0 participants
|
0 participants
|
SECONDARY outcome
Timeframe: Baseline and week 12/EoTPopulation: FAS population with available data at baseline and at week 12/EoT.
The UPSA-2-ER assesses the functional abilities of the participant with schizophrenia in 6 domains: household management, communication, financial skills, transportation, comprehension/planning and medication management. The UPSA-2-ER total score has a range from 0 to 105. A higher score indicates less impairment.
Outcome measures
| Measure |
Placebo
n=55 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=40 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=44 Participants
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Change From Baseline to Week 12/EoT in University of California San Diego Performance-based Skills Assessment-2 Extended Range (UPSA-2-ER) Total Score
|
3.11 units on a scale
Standard Error 1.06
|
3.86 units on a scale
Standard Error 1.23
|
2.56 units on a scale
Standard Error 1.17
|
SECONDARY outcome
Timeframe: Predose: day 7, day 14, day 21, day 42 and day 84/EoTPopulation: The pharmacokinetic analysis set (PKAS) consisted of all participants who took at least 1 dose of study drug and who had at least 1 plasma concentration. PKAS population with available data at each time point.
Ctrough concentration for ASP4345 was reported.
Outcome measures
| Measure |
Placebo
n=54 Participants
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=60 Participants
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Concentration at Trough Level (Ctrough) for ASP4345
Day 7 Pre-dose
|
175.041 nanogram per milliliter (ng/mL)
Standard Deviation 159.345
|
483.84 nanogram per milliliter (ng/mL)
Standard Deviation 452.65
|
—
|
|
Concentration at Trough Level (Ctrough) for ASP4345
Day 14 Pre-dose
|
182.903 nanogram per milliliter (ng/mL)
Standard Deviation 165.499
|
428.88 nanogram per milliliter (ng/mL)
Standard Deviation 516.14
|
—
|
|
Concentration at Trough Level (Ctrough) for ASP4345
Day 21 Pre-dose
|
172.040 nanogram per milliliter (ng/mL)
Standard Deviation 128.812
|
384.48 nanogram per milliliter (ng/mL)
Standard Deviation 331.71
|
—
|
|
Concentration at Trough Level (Ctrough) for ASP4345
Day 42 Pre-dose
|
207.145 nanogram per milliliter (ng/mL)
Standard Deviation 167.127
|
471.78 nanogram per milliliter (ng/mL)
Standard Deviation 546.00
|
—
|
|
Concentration at Trough Level (Ctrough) for ASP4345
Day 84 Pre-dose
|
204.914 nanogram per milliliter (ng/mL)
Standard Deviation 154.615
|
433.56 nanogram per milliliter (ng/mL)
Standard Deviation 427.12
|
—
|
Adverse Events
Placebo
ASP4345 50 mg
ASP4345 150 mg
Serious adverse events
| Measure |
Placebo
n=100 participants at risk
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=65 participants at risk
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=68 participants at risk
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Injury, poisoning and procedural complications
Head injury
|
0.00%
0/100 • Baseline up to EoS (week 14)
|
1.5%
1/65 • Number of events 1 • Baseline up to EoS (week 14)
|
0.00%
0/68 • Baseline up to EoS (week 14)
|
|
Psychiatric disorders
Psychotic disorder
|
0.00%
0/100 • Baseline up to EoS (week 14)
|
1.5%
1/65 • Number of events 1 • Baseline up to EoS (week 14)
|
1.5%
1/68 • Number of events 1 • Baseline up to EoS (week 14)
|
|
Psychiatric disorders
Suicidal ideation
|
1.0%
1/100 • Number of events 2 • Baseline up to EoS (week 14)
|
0.00%
0/65 • Baseline up to EoS (week 14)
|
0.00%
0/68 • Baseline up to EoS (week 14)
|
|
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
|
0.00%
0/100 • Baseline up to EoS (week 14)
|
1.5%
1/65 • Number of events 1 • Baseline up to EoS (week 14)
|
0.00%
0/68 • Baseline up to EoS (week 14)
|
Other adverse events
| Measure |
Placebo
n=100 participants at risk
Participants on stable doses of antipsychotic medication received ASP4345 placebo matching capsules, orally, once daily for 12 weeks.
|
ASP4345 50 mg
n=65 participants at risk
Participants on stable doses of antipsychotic medication received ASP4345 50 mg, capsules, orally, once daily for 12 weeks.
|
ASP4345 150 mg
n=68 participants at risk
Participants on stable doses of antipsychotic medication received ASP4345 150 mg, capsules, orally, once daily for 12 weeks.
|
|---|---|---|---|
|
Nervous system disorders
Dizziness
|
0.00%
0/100 • Baseline up to EoS (week 14)
|
1.5%
1/65 • Number of events 1 • Baseline up to EoS (week 14)
|
5.9%
4/68 • Number of events 4 • Baseline up to EoS (week 14)
|
|
Nervous system disorders
Headache
|
3.0%
3/100 • Number of events 3 • Baseline up to EoS (week 14)
|
6.2%
4/65 • Number of events 4 • Baseline up to EoS (week 14)
|
4.4%
3/68 • Number of events 3 • Baseline up to EoS (week 14)
|
Additional Information
Clinical Trial Disclosure
Astellas Pharma Global Development, Inc.
Results disclosure agreements
- Principal investigator is a sponsor employee Institute and/or Principal Investigator may publish trial data generated at their specific study site after Sponsor publication of the multi-center data. Sponsor must receive a site's manuscript prior to publication for review and comment as specified in the Investigator Agreement.
- Publication restrictions are in place
Restriction type: OTHER