The primary purpose is to evaluate the safety and tolerability of ASP6981 in participants with schizophrenia. Also primary purpose is to evaluate the pharmacodynamics of ASP6981 in participants with schizophrenia as measured by cognitive function and neurophysiological biomarkers. The secondary purpose of this study is to evaluate the pharmacokinetics of ASP6981 in participants with schizophrenia.
This study will evaluate ASP6981 in stable participants with schizophrenia on stable doses of up to 2 second generation antipsychotic drugs for at least 2 months prior to screening. Participants will be enrolled and randomized into 1 of 4 treatment sequences: AB, BA, CD, DC. Screening period: After a screening period of up to 29 days prior to study drug administration, eligible participants will be admitted to the clinical unit on day -3. Investigational period: Enrolled participants will be randomized to receive either ASP6981 or Placebo first and then will be crossed over to receive the opposite intervention. The study will consist of two treatment periods of 14 days separated by a washout period of 14 days. Participants will be discharged from the clinical unit on day 15 for the washout period. Washout may be extended up to a maximum of 21 days depending on the participant's availability. Follow up: Participants will return to the clinical unit for an End of Study Visit (ESV) on day 28 of period 2 or, if the participant terminated early from the study, 14 days after the last dose of study drug.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
32
Cctmg/Parexel
Glendale, California, United States
Community Clinical Research
Austin, Texas, United States
Safety and tolerability assessed by nature, frequency and severity of adverse events (AEs)
An AE is any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. 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.
Time frame: Up to End of Study (up to a maximum of 65 days)
Number of participants with vital signs abnormalities and/or adverse events related to treatment
Number of participants with potentially clinically significant vital sign values.
Time frame: Up to End of Study (up to a maximum of 65 days)
Number of participants with laboratory value abnormalities and/or adverse events related to treatment
Number of participants with potentially clinically significant laboratory values.
Time frame: Up to End of Study (up to a maximum of 65 days)
Safety and tolerability assessed by 12-lead electrocardiogram (ECG)
Routine 12 lead ECGs will be performed after the participant has been in a supine position for at least 5 minutes. Any clinically significant adverse changes on the ECG will be reported as (serious) Adverse Event.
Time frame: Up to End of Study (up to a maximum of 65 days)
Safety and tolerability assessed by C-SSRS
C-SSRS: Columbia - Suicide Severity Rating Scale. The C SSRS is a rating scale that assesses the full spectrum of suicidality: suicide ideation, intensity of ideation, suicidal behaviors and actual attempts.
Time frame: Up to 50 days
Safety and tolerability assessed through metabolic parameter: waist circumference
Waist circumference will be summarized by ASP6981 treatment group and pooled placebo.
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Time frame: Up to End of Study (up to a maximum of 65 days)
Safety and tolerability assessed through metabolic parameter: lipid panel
Lipid panel will be summarized by ASP6981 treatment group and pooled placebo.
Time frame: Up to End of Study (up to a maximum of 65 days)
Safety and tolerability assessed through metabolic parameter: glucose level
Glucose level will be summarized by ASP6981 treatment group and pooled placebo.
Time frame: Up to End of Study (up to a maximum of 65 days)
Safety and tolerability assessed by weight
Weight to be summarized by ASP6981 treatment group and pooled placebo.
Time frame: Up to End of Study (up to a maximum of 65 days)
Safety and tolerability assessed for movement disorder using AIMS
AIMS: Abnormal Involuntary Movement Scale. The AIMS aids in the early detection of tardive dyskinesia as well as providing a method for on going surveillance. The AIMS is a checklist and uses a 5 point rating scale for recording scores for 7 body areas: face, lips, jaw, tongue, upper extremities, lower extremities and trunk.
Time frame: Up to 50 days
Safety and tolerability assessed for movement disorder using BARS
BARS: Barnes Akathisia Rating Scale. The BARS is a rating scale that is used to assess the severity of drug induced akathisia.
Time frame: Up to 50 days
Safety and tolerability assessed for movement disorder using SAS
SAS: Simpson Angus Scale. The SAS is a 10 item scale used to rate adverse neurological effects of antipsychotic medications more broadly. It involves direct observation and a brief neurological examination. Rating requires the investigator to observe the participant's gait and check for tremor, excessive salivation and rigidity in the arms, shoulder and neck. Each item is rated from 0 to 4 and a total score can be obtained.
Time frame: Up to 50 days
Pharmacodynamics (PD) of ASP6981 assessed through Cogstate: general composite score of executive function and memory cognitive testing
Cogstate testing composed by Groton Maze Learning, One Back, One Card and International Shopping List tests: specific Cogstate's panels for schizophrenia.
Time frame: Day 14: period 1 and 2
PD of ASP6981 assessed through electroencephalogram (EEG): electrophysiological measures of P300 (P3a, P3b) and Mismatch Negativity (MMN)
EEG will be recorded after cognitive testing.
Time frame: Day 14: period 1 and 2
Pharmacokinetics (PK) of ASP6981 and its metabolites, if necessary (plasma): Tmax
Tmax: time of maximum concentration
Time frame: Day 1 and day 14: period 1 and 2
PK of ASP6981 and its metabolites, if necessary (plasma): Cmax
Cmax: maximum concentration
Time frame: Day 1 and day 14: period 1 and 2
PK of ASP6981 and its metabolites, if necessary (plasma): AUC12
AUC12: Area under the concentration time curve from the time of dosing to 12 hours postdose
Time frame: Day 1: period 1 and 2
PK of ASP6981 and its metabolites, if necessary (plasma): Ctrough
Ctrough: Concentration immediately prior to dosing at multiple dosing
Time frame: Day 7 and day 14: period 1 and 2 and day 13 of period 2
PK of ASP6981 and its metabolites, if necessary (plasma): AUCtau
AUCtau: Area under the concentration time curve from the time of dosing to the start of the next dosing interval
Time frame: Day 14: period 1 and 2
PD of ASP6981 assessed through Cogstate: composite score of attention cognitive testing
Cogstate testing composed by Detection Test and Identification.
Time frame: Day 14: period 1 and 2
PD of ASP6981 assessed through EEG: electrophysiological measures of Auditory Steady State Response (ASSR), N100, P200 and resting state
EEG will be recorded after cognitive testing.
Time frame: Day 14: period 1 and 2