This is a Phase 2, multicenter, randomized, double-blind, placebo-controlled, parallel-group, 6-week trial to evaluate the efficacy, safety, and tolerability of 2 fixed doses of CVL-231 (Emraclidine) (10 mg QD and 30 mg QD) in male and female participants who have schizophrenia and are experiencing an acute exacerbation of psychosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
385
Matching placebo, oral (tablet), once per day for 6 weeks
Emraclidine 10 mg, oral (tablet), once per day for 6 weeks
Emraclidine 30 mg, oral (tablet), once per day for 6 weeks
Little Rock, Arkansas
Little Rock, Arkansas, United States
Change From Baseline at Week 6 in the Positive and Negative Syndrome Scale (PANSS) Total Score
The PANSS measures symptom severity of participants with schizophrenia and contains 7 positive symptom scales, 7 negative system scales, and 16 general psychopathology symptom scales. Participants are rated from 1 to 7 on each symptom scale with a total minimum score of 30 and a maximum score of 210. A decrease in PANSS total score correlates with an improvement in schizophrenia symptoms.
Time frame: Baseline through Week 6
Change From Baseline at Week 6 in the Clinical Global Impression - Severity (CGI-S Score)
The CGI-S captures clinician's response to: "Considering your total clinical experience, how mentally ill is the participant at this time?" The clinician's answer was based on the following scale: 0 = not assessed; 1 = normal, not at all ill; 2 = borderline mentally ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; 7 = among the most extremely ill participants. Negative changes from Baseline indicate less mental illness.
Time frame: Baseline through Week 6
Change From Baseline at All Time Points in Positive and Negative Syndrome Scale (PANSS) Total Score
The PANSS measures symptom severity of participants with schizophrenia and contains 7 positive symptom scales, 7 negative system scales, and 16 general psychopathology symptom scales. Participants are rated from 1 to 7 on each symptom scale with a total minimum score of 30 and a maximum score of 210. A decrease in PANSS total score correlates with an improvement in schizophrenia symptoms.
Time frame: Baseline; Weeks 1, 2, 3, 4, 5, and 6
Change From Baseline at All Time Points in the Clinical Global Impression - Severity (CGI-S) Score
The CGI-S captures clinician's response to: "Considering your total clinical experience, how mentally ill is the participant at this time?" The clinician's answer was based on the following scale: 0 = not assessed; 1 = normal, not at all ill; 2 = borderline mentally ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; 7 = among the most extremely ill participants. Negative changes from Baseline indicate less mental illness.
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Anaheim, California
Anaheim, California, United States
Garden Grove, California
Garden Grove, California, United States
Lemon Grove, California
Lemon Grove, California, United States
Montclair, California
Montclair, California, United States
Riverside, California
Riverside, California, United States
San Diego, California
San Diego, California, United States
Hialeah, Florida
Hialeah, Florida, United States
Hollywood, Florida
Hollywood, Florida, United States
Mangonia Park, Florida
Mangonia Park, Florida, United States
...and 15 more locations
Time frame: Baseline; Weeks 1, 2, 3, 4, 5, and 6
Percentage of Responders at Week 6 (Responders Defined as ≥30% Reduction From Baseline in Positive and Negative Syndrome Scale [PANSS] Total Score)
The PANSS measures symptom severity of participants with schizophrenia and contains 7 positive symptom scales, 7 negative system scales, and 16 general psychopathology symptom scales. Participants are rated from 1 to 7 on each symptom scale with a total minimum score of 30 and a maximum score of 210. A decrease in PANSS total score correlates with an improvement in schizophrenia symptoms. A PANSS responder is defined as a participant with at least a 30% decrease in PANSS total score compared to Baseline at Week 6 visit or the early termination visit. If a participant discontinued and did not have an early termination visit, the participant's last assessment was considered.
Time frame: Baseline through Week 6
Number of Participants With Treatment Emergent Adverse Event (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs)
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 causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study drug. 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 study drug.
Time frame: From first dose of study drug until 28 days following last dose of study drug (up to Week 10)
Number of Participants With Clinically Significant Changes in Electrocardiogram (ECGs)
12-lead electrocardiogram (ECG) recordings were obtained after the participant had been supine and at rest for at least 3 minutes.
Time frame: Baseline; from first dose of study drug up to Week 6
Number of Participants With Clinically Significant Changes in Clinical Laboratory Assessments
Clinical laboratory tests were performed at scheduled study visits, and the investigator recorded any clinically significant changes.
Time frame: Baseline; from first dose of study drug up to Week 6
Number of Participants With Clinically Significant Changes in Vital Sign Measurements
Vital signs were obtained after the participant had been supine and at rest for 3 minutes and included temperature, systolic and diastolic blood pressure, respiratory rate, and heart rate. Participants' body weights were also measured and recorded.
Time frame: Baseline; from first dose of study drug up to Week 6
Number of Participants With Clinically Significant Changes in Physical and Neurological Examination Results
The number of participants with clinically significant changes in physical and neurological examination results was documented.
Time frame: Baseline; from first dose of study drug up to Week 6
Number of Participants With Suicide-Related Treatment-Emergent Events Assessed Using the Columbia Suicide-Severity Rating Scale (C-SSRS)
The C-SSRS rates an individual's degree of suicidal ideation (SI) on a scale, ranging from "wish to be dead" to "active suicidal ideation with specific plan and intent." The scale identifies SI severity and intensity, which may be indicative of an individual's intent to commit suicide. C-SSRS SI severity subscale ranges from 0 (no SI) to 5 (active SI with plan and intent).
Time frame: Baseline; from first dose of study drug up to Week 6
Change From Baseline in Simpson Angus Scale (SAS) Total Score
The SAS consists of a list of 10 symptoms of Parkinsonism. Each item is rated on a 5-point scale, with a score of 0 representing absence of symptoms and a score of 4 representing a severe condition. The SAS total score is the sum of the scores for all 10 items. Negative changes from Baseline indicate an improvement in symptoms.
Time frame: Baseline; Weeks 3 and 6
Change From Baseline in Abnormal Involuntary Movement Scale (AIMS) Movement Rating Score
The Abnormal Involuntary Movement Scale assessment consists of 10 items describing symptoms of dyskinesia. Facial and oral movements (items 1-4), extremity movements (items 5 and 6), and trunk movements (item 7) are observed unobtrusively while the participant is at rest, and the investigator also makes global judgments on the participant's dyskinesias (items 8-10). Each item is rated on a 5-point scale, with a score of 0 representing absence of symptoms (for item 10, no awareness), and a score of 4 indicating a severe condition (for item 10, awareness, severe distress). In addition, the AIMS includes 2 yes/no questions that address the participant's dental status. The AIMS Movement Rating Score is defined as the sum of individual scores from items 1-7, ranging from 0 to 28. A lower score indicates less severe or absent abnormal movements. A negative change in the mean from Baseline indicates improvement in the severity of abnormal involuntary movements.
Time frame: Baseline; Weeks 3 and 6
Change From Baseline in Barnes Akathisia Rating Scale (BARS) Global Clinical Evaluation Score
The BARS consists of 4 items related to akathisia: The first 3 items are rated on a 4-point scale, with a score of 0 representing absence of symptoms and a score of 3 representing a severe condition. The global clinical evaluation is made on a 6-point scale, with a score of 0 representing absence of symptom and a score of 5 representing severe akathisia. Negative changes from Baseline indicate an improvement in symptoms.
Time frame: Baseline; Weeks 3 and 6