A Trial of 15 and 30 mg Doses of CVL-231 (Emraclidine) in Participants With Schizophrenia

AbbVie391 enrolled

Overview

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) (15 mg QD and 30 mg QD) in male and female adult participants who have schizophrenia and are experiencing an acute exacerbation of psychosis.

The trial included up to a 15-day Screening Period (up to a maximum of 21 days allowed with approval of the medical monitor), a 45-day Inpatient Treatment Period, and a 28-day Follow-up Period. Each participant participated in the trial for up to approximately 13 weeks.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

391

Conditions

Schizophrenia

Interventions

Emraclidine 15 mgDRUG

Emraclidine 15 mg, oral (tablet), once per day (QD) for 6 weeks

Emraclidine 30 mgDRUG

Emraclidine 30 mg, oral (tablet), QD for 6 weeks

PlaceboDRUG

Matching placebo, oral (tablet), QD for 6 weeks

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Primary diagnosis of schizophrenia per DSM-5, as confirmed by the MINI for Psychotic Disorders. * CGI-S ≥4 (moderately to severely ill) at the time of signing the ICF and Baseline. * PANSS Total Score between 85 and 120, inclusive, at the time of signing the ICF and at Baseline. * Experiencing an acute exacerbation or relapse of psychotic symptoms, with onset less than 60 days prior to signing the ICF. * Willing to discontinue all prohibited medications to meet protocol-required washouts prior to and during the trial period. * Body mass index of 18.0 to 40.0 kg/m2 and a total body weight ≥50 kg (110 lbs). * Ability, in the opinion of the investigator, to understand the nature of the trial, participate in trial visits, and comply with protocol requirements. Exclusion Criteria: * Current DSM-5 diagnosis other than schizophrenia (note: anxiety symptoms secondary to schizophrenia are allowed); Acute depressive symptoms within 30 days prior to signing the ICF that require treatment with an antidepressant are exclusory. Acute manic symptoms within 30 days prior to signing the ICF that require treatment with a mood stabilizer are exclusory. * Any of the following: * Schizophrenia considered resistant/refractory to antipsychotic treatment by history (failure to respond to 2 or more courses of adequate pharmacological treatment defined as an adequate dose per label and a treatment duration of at least 4 weeks) * History of response to clozapine treatment only or failure to respond to clozapine treatment * Any of the following regarding history of schizophrenia: * Time from initial onset of schizophrenia \<2 years based on prior records or participant self-report * Presenting with an initial diagnosis of schizophrenia * Presenting for the first time with an acute psychotic episode requiring treatment * Reduction (improvement) in PANSS total score of ≥20% between Screening and Baseline. * Current or past history of significant cardiovascular, pulmonary, gastrointestinal, renal, hepatic, metabolic, genitourinary, endocrine (including diabetes mellitus), malignancy (except for basal cell carcinoma of the skin and cervical carcinoma in situ, at the discretion of the investigator), hematological, immunological, neurological, or psychiatric disease that, in the opinion of the investigator or medical monitor, could compromise either participant safety or the results of the trial. * Active central nervous system infection, demyelinating disease, degenerative neurological disease, brain tumor, prior hospitalization for severe head trauma, seizures (excluding febrile seizures in childhood), or any central nervous system disease deemed to be progressive during the course of the trial that may confound the interpretation of the trial results * Diagnosis of moderate to severe substance or alcohol-use disorder (excluding nicotine or caffeine) as per DSM-5 criteria within 12 months prior to signing the ICF. * Risk for suicidal behavior as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS) and investigator's clinical assessment. * Any condition that could possibly affect drug absorption. * Use of prohibited medications prior to randomization within the required wash-out period or likely to require prohibited concomitant therapy during the trial. * Clinically significant abnormal findings on the physical examination, medical history review, ECG, or clinical laboratory results at screening. * Positive pregnancy test result prior to receiving IMP. Note: female participants who are pregnant, breastfeeding, or planning to become pregnant during IMP treatment or within 7 days after the last dose of IMP are also excluded.

Locations (26)

Bentonville, Arkansas

Bentonville, Arkansas, United States

Outcomes

Primary Outcomes

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. Baseline was defined as the last value obtained prior to initiation of investigational medicinal product (IMP). Change from baseline for a given endpoint was defined as the value on a given Study Day (Time Point) minus the Baseline Value. A decrease in PANSS total score correlates with an improvement in schizophrenia symptoms.

Time frame: Baseline through Week 6

Secondary Outcomes

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 rated on the following 7-point scale: 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. Baseline was defined as the last value obtained prior to initiation of investigational medicinal product (IMP). Change from baseline for a given endpoint was defined as the value on a given Study Day (Time Point) minus the Baseline Value. 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

Data from ClinicalTrials.gov

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Bellflower, California

Bellflower, California, United States

La Habra, California

La Habra, California, United States

San Diego, California

San Diego, California, United States

Sherman Oaks, California

Sherman Oaks, California, United States

Torrance, California

Torrance, California, United States

New Haven, Connecticut

New Haven, Connecticut, United States

Homestead, Florida

Homestead, Florida, United States

Miami, Florida

Miami, Florida, United States

Miami Lakes, Florida

Miami Lakes, Florida, United States

...and 16 more locations

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 rated on the following 7-point scale: 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. Baseline was defined as the last value obtained prior to initiation of Emraclidine. Change from baseline for a given endpoint was defined as the value on a given Study Day (Time Point) minus the Baseline Value. Negative changes from Baseline indicate less mental illness.

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 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 PANSS responder is defined as a participant with at least a 30% change in PANSS total score compared to baseline at Week 6 or the early termination visit. If a subject discontinued and did not have an early termination visit, the subject'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)

Assessment of clinically significant changes in electrocardiogram measures measured by 12-lead ECG recording after the participant has been supine and at rest for at least 3 minutes.