Bipolar disorder is a severe chronic mood disorder that affects up to 4% of the adult population and 1.8% of the pediatric population in the United States. The treatment of the depressive episodes of bipolar disorder in the pediatric population has not been as widely studied as the treatment of depressive episodes in bipolar disorder in adults, therefore pharmacotherapeutic options are limited. Given the change in disease state and safety demonstrated in adults with depressive episodes associated with bipolar I disorder, the purpose of this study is to evaluate the change in disease state and safety of cariprazine in the treatment of depressive episodes associated with bipolar I disorder in the pediatric population. Cariprazine is an approved drug for the treatment of depressive episodes in adult participants with bipolar I disorder. Study doctors put participants in 1 of 2 groups, called treatment arms. There is a 1 in 2 chance that a participant will be assigned to placebo. Around 380 Participants ages 10-17 years with bipolar I disorder will be enrolled in approximately 60 sites worldwide. Participants receiving the study drug will receive Dose A or B of Cariprazine based on age and weight. At Week 3, participants with insufficient response will have their dose increased to Dose B or Dose C, while participants with sufficient response will continue receiving the Dose A or B for the remainder of the treatment period. The treatment period will be followed by a safety follow-up (SFU) period for 4 weeks. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular weekly visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
380
Oral Capsule
Oral Capsule
Pillar Clinical Research /ID# 226504
Bentonville, Arkansas, United States
COMPLETEDAdvanced Research Center /ID# 227073
Anaheim, California, United States
RECRUITINGCare Access Research /ID# 226316
Beverly Hills, California, United States
COMPLETEDProScience Research Group /ID# 226223
Culver City, California, United States
Number of Participants with Adverse Events
An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a casual relationship with this treatment. The investigator assesses the relationship of each event to the use of the study. A serious adverse event (SAE) is an event that results in death, is life threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event, that based on medical judgment, may jeopardize the participant and may require medical or surgical intervention to prevent any of the outcomes listed above. Treatment-emergent adverse events/ treatment emergent serious adverse events (TEAEs/TESAEs) are defined as any event that began or worsened in severity on or after the first dose of the study drug.
Time frame: Baseline (Week 0) to Week 10
Abnormal Change from Baseline in Vital Signs
Change in vital signs like systolic and diastolic blood pressure will be assessed.
Time frame: Baseline (Week 0) to Week 10
Number of Participants with Incidence of Abnormal Clinical Laboratory Test Results
Number of participants with incidence of abnormal clinical laboratory test results like hematology will be assessed.
Time frame: Baseline (Week 0) to Week 6
Change in Electrocardiogram (ECG)
12 -lead resting ECGs will be recorded. Parameters include RR interval, PR interval, QT interval, and QRS duration.
Time frame: Baseline (Week 0) to Week 6
Change From Baseline in Simpson-Angus Scale (SAS)
SAS is a 10-item rating scale for assessment of antipsychotic-induced parkinsonism in both clinical practice and research settings. Each item ranges from 0 (normal) to 4 (extreme symptoms). The scale consists of 1 item measuring gait (hypokinesia), 6 items measuring rigidity, and 3 items measuring glabella tap, tremor, and salivation, respectively.
Time frame: Baseline (Week 0) to Week 6
Change from Baseline in Columbia-Suicide Severity Rating Scale (C-SSRS)
The C-SSRS is a clinician-rated instrument that reports the severity of both suicidal ideation and behavior, with a higher score denoting more severe suicidal ideation and behavior.
Time frame: Baseline (Week 0) to Week 10
Change From Baseline in Barnes Akathisia Rating Scale (BARS)
BARS is a 4-item rating scale used to assess drug-induced akathisia. The scale comprises items for rating the observable restless movements that characterize the condition, the subjective awareness of restlessness, and any distress associated with the akathisia (each on a 4-point scale from normal \[0\] to severe \[3\]). In addition, there is a global severity for akathisia rated on a 6-point scale (absent \[0\] to severe akathisia \[5\]).
Time frame: Baseline (Week 0) to Week 6
Change From Baseline in Abnormal Involuntary Movement Scale (AIMS)
AIMS assesses abnormal involuntary movements, such as tardive dyskinesia, associated with antipsychotic drugs; it measures facial, oral, extremities, and trunk movements, as well as the participant's awareness of abnormal movements. The first 10 items are rated on a none (0) to severe (4) scale. There are an additional 2 items on dental status that are answered yes or no.
Time frame: Baseline (Week 0) to Week 6
Change in Children's Depression Rating Scale - Revised (CDRS-R) Total Score
The CDRS-R is a 17-item clinician-administered scale specifically developed for the assessment of depressive symptoms in children and adolescents. Total scores range from 17 to 113. In general, scores below 20 indicate an absence of depression, scores of 20 to 30 indicate borderline depression, and scores of 40 to 60 indicate moderate depression. The CDRS-R will be administered by a clinician with extensive professional training in mental illness.
Time frame: Baseline (Week 0) to Week 6
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National Institute of Clinical Research - Garden Grove /ID# 262835
Garden Grove, California, United States
COMPLETEDDuplicate_Alliance for Research - Long Beach /ID# 226522
Long Beach, California, United States
COMPLETEDCHOC Children's Hospital /ID# 260298
Orange, California, United States
RECRUITINGATP Clinical Research- Orange /ID# 253719
Orange, California, United States
RECRUITINGProspective Research Innovations Inc /ID# 240774
Rancho Cucamonga, California, United States
COMPLETEDInland Psychiatric Medical Group /ID# 274621
Redlands, California, United States
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