Safety, Tolerability, Pharmacokinetics and Efficacy of 180 mg Subcutaneous Risperidone From 6 mg Oral Risperidone

Sponsor
Indivior Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT03978832
Collaborator
(none)
69
1
1
10.5
6.6

Study Details

Study Description

Brief Summary

This study evaluates PERSERIS at a higher dose than what has been administered in previous clinical trials. Subjects with stable schizophrenia on a dose of 5-6 mg oral risperidone will be switched to PERSERIS at the higher dose, which is believed to be similar to the oral dose

Condition or Disease Intervention/Treatment Phase
Phase 4

Detailed Description

PERSERIS is an extended-release subcutaneous (SC) injectable suspension administered monthly for the treatment of schizophrenia in adults. PERSERIS was approved by the FDA at doses equivalent to 3 mg and 4 mg oral risperidone. Many patients require doses of 5-6 mg oral risperidone and above, and this study will test a higher dose of PERSERIS in order to meet this need.

Eligible subjects will initially be stabilized in the clinical unit on 6 mg oral risperidone for 5 days and transition to an approximate dose of PERSERIS by SC injection. PERSERIS will be administered every 28 days and subjects will be admitted to the clinical unit the day before, and remain in the unit for 3 days after each injection for pharmacokinetics (PK) and safety evaluations (a total of 8 days for the first injection including the stabilization period). Subjects will return to the clinic between injections for additional PK, safety and efficacy assessments at scheduled intervals until the next injection.

A total of 4 doses of PERSERIS will be administered. The 4th dose will evaluate an alternate site for injection, and will be administered in the back of the upper arm.

Subjects will return to the clinical unit for an end of study visit and will receive a follow up phone call to assess for adverse events one week after the end of study visit.

Study Design

Study Type:
Interventional
Actual Enrollment :
69 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Intervention Model Description:
The study will enroll subjects currently on a stable dose of 5 or 6 mg of oral risperidone. After screening, eligible subjects will be admitted to the clinical unit and stabilized on 6 mg daily (3 mg oral risperidone twice a day) for 5 days, followed by an additional 3 days, during which the first injection of PERSERIS will be administered. Subjects will then return to the clinical unit every 28 days for an additional 3 admit periods for subsequent PERSERIS injections (2 injections per visit).The study will enroll subjects currently on a stable dose of 5 or 6 mg of oral risperidone. After screening, eligible subjects will be admitted to the clinical unit and stabilized on 6 mg daily (3 mg oral risperidone twice a day) for 5 days, followed by an additional 3 days, during which the first injection of PERSERIS will be administered. Subjects will then return to the clinical unit every 28 days for an additional 3 admit periods for subsequent PERSERIS injections (2 injections per visit).
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
An Open-label Study to Assess the Safety, Tolerability, Pharmacokinetics, and Efficacy of 180 mg Risperidone Subcutaneous Injection (PERSERIS) Following a Switch From 6 mg Oral Risperidone in Patients With Clinically Stable Schizophrenia
Actual Study Start Date :
Jun 28, 2019
Actual Primary Completion Date :
May 12, 2020
Actual Study Completion Date :
May 12, 2020

Arms and Interventions

Arm Intervention/Treatment
Experimental: Oral Risperidone followed by PERSERIS

All subjects will receive 2 SC injections of PERSERIS at each study visit every 28 days for a total of 4 visits of 2 injections each. The first 3 visit injections will be administered in the abdomen and the final visit injections will be administered in the back of the upper arm.

Drug: PERSERIS
PERSERIS is an extended-release SC injectable suspension administered once-monthly
Other Names:
  • long acting risperidone
  • Drug: Risperidone
    Oral risperidone
    Other Names:
  • Risperdal
  • Outcome Measures

    Primary Outcome Measures

    1. Steady-state Average Plasma Concentration (Cavg,ss) of Risperidone and Total Active Moiety [0-12 hours post-dose on Day -1, and 0-672 hours after Dose 3]

      Cavg,ss for risperidone and total active moiety after oral and SC administration

    Secondary Outcome Measures

    1. Assessment of Local Injection Site Tolerability* [First injection at Day 1 until last injection administered at Day 85]

      Injection site tolerability was measured by injection site grading for redness, induration, swelling and tenderness/pain. These were graded on a scale from 0 to 4 for severity (none, mild, moderate, severe and potentially life-threatening)

    2. The Number of Participants With TEAEs as Assessed by Local Injection Site* [First injection at Day 1 until Day 120]

      The injection site was evaluated for adverse events by observation and examination by appropriately trained personnel.

    3. The Number of Participants With TEAEs as Assessed by Changes in Vital Signs [Time subjects sign the informed consent form throughout the study until EOS (Day 113)]

      Vital sign measurement was performed, including orthostatic blood pressure, and clinically significant changes were reported as adverse events (AE). Vital sign measurement also included measurement of pulse rate, oral temperature and respiratory rate. Determination of whether the changes were AEs was made by the investigator or a medically qualified designee. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range and the subject was clinically stable, a specific diagnosis was established, or the condition otherwise explained.

    4. The Number of Participants With TEAEs as Assessed by Changes in ECG [Time participants sign the informed consent form throughout the study until EOS (Day 113)]

      ECGs were performed, and clinically significant changes in parameters were reported as adverse events (AE). ECGs were performed after 5 minutes of rest, and ECG parameters including QT interval, PR interval, QRS interval and heart rate was recorded. The ECG measurements were evaluated during the visit and determination of whether any abnormalities were AEs was made by the investigator or a medically qualified designee. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range and the subject was clinically stable, a specific diagnosis was established, or the condition otherwise explained.

    5. The Number of Participants With TEAEs as Assessed by Changes in Body Weight [Time subjects sign the informed consent form throughout the study until EOS (Day 113)]

      Body weight, with shoes off, was measured and clinically significant changes in weight was reported as adverse events (AE). Determination of whether the changes were AEs was made by the investigator or a medically qualified designee. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range and the subject was clinically stable, a specific diagnosis was established, or the condition otherwise explained.

    6. The Number of Participants With TEAEs as Assessed by Changes in Laboratory Testing [Time subjects sign the informed consent form throughout the study until end of study (EOS) visit (Day 113)]

      Laboratory testing was performed by the local clinical laboratory accredited by the College of American Pathologists, and clinically significant changes from baseline were reported as AEs. Subjects were expected to fast for a minimum of 8 hours prior to blood draws for all laboratory assessments except at the screening visit. Prior to entering the study, any abnormal laboratory test results were to be considered not clinically significant. Any abnormal hematology, serum chemistry or urinalysis test result after study drug intake that was determined by the investigator or a medically qualified designee to be clinically significant was reported as an AE. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range or it was determined that resolution was not expected.

    7. The Number of Participants With TEAEs as Assessed by Extrapyramidal Symptoms (EPS) of Anti-psychotic Drug Treatment [Time subjects sign the informed consent form throughout the study until EOS (Day 113)]

      Safety of treatment was measured by administration of symptom questionnaires including AIMS, Barnes Akathisia Rating Scale (BARS) and Simpson-Angus Scale (SAS), as well as by assessment by the investigator or suitably qualified medical designee. The AIMS is a tool that aids in early detection and ongoing monitoring of tardive dyskinesia, a movement disorder. The BARS is a 4-item scale that detects the presence and severity of any drug-induced restlessness. The SAS is a 10-item scale used to detect the presence of drug-induced Parkinsonism (movement disorder seen in Parkinson's disease) and extrapyramidal side effects and evaluates symptom severity. Extrapyramidal symptoms include involuntary or uncontrollable movements, tremors, and muscle contractions.

    8. Positive and Negative Syndrome Scale (PANSS) [Baseline, defined as last assessment prior to first injection, through Day 113 (EOS)]

      Clinical outcome (efficacy endpoint) as measured by change from baseline in PANSS scores was measured. PANSS is a medical scale designed to measure schizophrenia symptom severity utilizing a 30 item, 7-point rating scheme. The PANSS Is scored by a summation of ratings across items, with a total potential range of 7-210; higher results indicate greater severity of illness. Only total score changes from baseline are reported here.

    9. Clinical Global Impression-Severity of Illness Scale (CGI-S) [Baseline through EOS (Day 113)]

      Clinical outcome (efficacy endpoint) as measured by change from baseline in CGI-S scores was measured. The CGI-S is a measurement of the total severity of illness where one question is assessed. Responses range from 0 (not assessed) to 7 (most extremely ill).

    10. Columbia-Suicide Severity Rating Scale (C-SSRS)-Change [Screening through EOS (Day 113)]

      Significant changes from baseline in C-SSRS scores were reported as adverse events. The C-SSRS is based on a categorization of thoughts and behavior that are identified as related to suicidal behavior. The scale captures the occurrence, severity and frequency of suicide related thoughts and behaviors throughout lifetime at screening and for the time interval since last administration during a study. Responses are indicated as yes (thought or behavior did occur) or no (thought or behavior did not occur). If a yes response is received, then follow up questions are asked. The outcome of the C-SSRS is a numerical score obtained from each of the categories. Scores can range from 0-25, indicating the intensity rating, and any score greater than 0 may indicate the need for mental health intervention. Higher scores indicate greater intensity (i.e. worse outcome).

    11. Safety as Measured by Columbia-Suicide Severity Rating Scale (C-SSRS) Scores [Screening through EOS (Day 113)]

      Safety of treatment was measured by characterization of thoughts and behavior related to suicidal behavior. This was assessed by administration of the C-SSRS at designated visits. The scale captures the occurrence, severity and frequency of suicide related thoughts and behaviours throughout lifetime at screening and for the time interval since last administration during a study. Questions solicit the type of information needed to determine if a suicide-related thought or behavior occurred.

    12. Minimum Plasma Concentration Over the Dosing Interval [Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).]

      Minimum observed plasma concentration of risperidone, 9-hydroxyrisperidone (9-OH) and total active moiety over the dosing interval after oral dosing and SC doses 1, 3 and 4

    13. Maximum Plasma Concentration Over the Dosing Interval [Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4)]

      Maximum observed plasma concentration of risperidone, 9-hydroxyrisperidone (9-OH) and total active moiety over the dosing interval after oral dosing and SC doses 1, 3 and 4

    14. Percent Fluctuation in Concentration Over the Dosing Interval [Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4)]

      Plasma concentration variation of risperidone, 9-OH and total active moiety over the dosing interval was measured by percent fluctuation after oral dosing and SC doses 1, 3 and 4 at steady state.

    15. Area Under the Plasma Concentration-time Curve Over the Dosing Interval [Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).]

      Area under the plasma concentration-time curve (AUC) was measured for risperidone, 9-OH and total active moiety.

    16. Average Plasma Concentration (Cavg) Over the Dosing Interval of Risperidone, 9-OH and Total Active Moiety [Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).]

      Average plasma concentration of risperidone, 9-hydroxyrisperidone (9-OH) and total active moiety over the dosing interval after oral dosing and SC doses 1, 3 and 4.

    17. Trough Plasma Concentration [Calculated over the dosing interval (0-672 hours) after Dose 1, 3 or 4.]

      Trough (pre-dose) plasma concentrations were measured for risperidone, 9-OH and total active moiety for SC doses 1, 3 and 4

    18. Time to Occurrence of Maximum Concentration [Calculated over the overall dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).]

      Time to maximal observed plasma concentration (Tmax) for risperidone, 9-OH, and total active moiety after oral dosing and SC doses 1, 3 and 4.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 65 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Diagnosis of schizophrenia

    • Clinically stable as defined as no hospitalizations for acute exacerbations within 3 months of screening and Screening PANSS score ≤70

    • Total body mass index (BMI) between 18 and 35 kg/m2

    • Given written informed consent

    Exclusion Criteria:
    • Received a once-monthly long-acting injectable (LAI) antipsychotic within 60 days of screening and a once every 3 month LAI antipsychotic within 120 days of screening

    • Taking the following concurrent or over the counter (OTC) products:

    1. Inducers or inhibitors of CYP2D6 within 14 days or 5 half-lives whichever is greater prior to study screening

    2. Bupropion, chlorpheniramine, cimetidine, clomipramine, doxepin or quinidine within 30 days prior to study screening

    3. Clozapine, phenothiazines, aripiprazole, haloperidol or any other antipsychotic other than oral risperidone within 14 days prior to study screening

    4. Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) within 30 days prior to study screening

    5. Opioids or opioid-containing analgesics within 14 days prior to study screening

    6. Medications, in the addition to those listed above which in the opinion of the Investigator in conjunction with the medical monitor, may be expected to significantly interfere with the metabolism or excretion of risperidone and/or 9-hydroxyrisperidone, that may be associated with a significant drug interaction with risperidone, or that may pose a significant risk to subjects' participation in the study. The medical monitor should be contacted with any questions regarding the use of CYP2D6 or 3A4 inducers or inhibitors in particular.

    • History of cancer (with the exception of resected basal cell or squamous cell carcinoma of the skin) unless they have been disease free for ≥5 years.

    • Another active medical condition or organ disease that may either compromise subject safety or interfere with the safety and/or outcome evaluation of the study drug.

    • Evidence or history of a significant hepatic disorder that may either compromise subject safety or interfere with the safety and/or outcome evaluation of the study drug. Individuals with acute or chronic hepatitis (including but not limited to hepatitis B or C); or individuals with 1) total bilirubin >1.5x the upper limit of normal (ULN) and/or 2) alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3x ULN will be excluded.

    • A history of renal disease, or a creatinine clearance of less than 60 mL/min (as determined by the Cockcroft-Gault formula).

    • A history of orthostatic hypotension, syncope, significant low white blood cell (WBC) count (i.e., based on absolute neutrophil count or drug-induced leukopenia or other medical conditions including, but not limited to, history of heart attack (i.e., myocardial infarction) or brain injury (i.e., traumatic with loss of consciousness and/or cardiovascular accident) within a year of Screening and clinically significant low blood pressure or arrhythmias as interpreted by the principal investigator (PI).

    • Corrected QT interval [Fridericia's calculation (QTcF)] >450 msec (male) or >470 msec (female) at screening or prior to administration of the 1st dose of PERSERIS, or with a known history of Torsades de Points, or family member with sudden unexplained cardiac death.

    • Known to have AIDS (acquired immunodeficiency syndrome) or to be HIV (human immunodeficiency virus) positive.

    • Suicidal ideation with intent and plan, as assessed by affirmative answers to C-SSRS questions 4 and 5 of the ideation section,or suicide attempts within the last 6 months as noted on the C-SSRS, or subjects with uncontrolled depression in the opinion of the Investigator.

    • Known diagnosis of type 1 diabetes or subjects with Haemoglobin A1c (HbA1c) >8.0% at screening.

    • Participated in a clinical trial within 30 days prior to study screening.

    • Significant traumatic injury, major surgery or open biopsy within 30 days prior to study screening.

    • Meet the criteria for the diagnosis of current moderate or severe substance use disorder.

    • Prior allergic reactions, sensitivities, or other known contraindications to any component of PERSERIS.

    • Women of childbearing potential who are pregnant or breastfeeding, seeking pregnancy or failing to use adequate contraceptive methods during the study.

    • Positive urine drug screen (UDS) anytime through Day -1 for opioids, cocaine, amphetamines, methadone, cannabinoids, barbiturates, benzodiazepines, methamphetamine and phencyclidine, unless the positive screen is determined to be secondary to an allowable concomitant medication. If a positive UDS is possibly the result of a subject's use of OTC or prescription medications, a repeat urine drug screen may be permissible. Study site personnel should contact the medical monitor for approval to retest.

    • Tardive dyskinesia as assessed by a score of ≥2 on Item 8 of the Abnormal Involuntary Movement Scale (AIMS) at Screening.

    • Epilepsy or other seizure disorders, Parkinson's disease or dementia.

    • History of neuroleptic malignant syndrome.

    • Previously injected with PERSERIS within 6 months prior to screening.

    • Unable, in the opinion of the PI, to comply fully with the study requirements.

    • Determined to be poor metabolisers, intermediate metabolisers or ultra-rapid metabolisers for CYP2D6 genotype.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Collaborative Neuroscience Network Garden Grove California United States 92845

    Sponsors and Collaborators

    • Indivior Inc.

    Investigators

    • Principal Investigator: David Walling, Collaborative Neuroscience Network

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Indivior Inc.
    ClinicalTrials.gov Identifier:
    NCT03978832
    Other Study ID Numbers:
    • INDV-7000-401
    First Posted:
    Jun 7, 2019
    Last Update Posted:
    Jul 7, 2021
    Last Verified:
    Jun 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details The study recruited participants from the community between June and December 2019. Participants were on a stable dose of 5 mg or 6 mg of oral risperidone daily; any daily or twice daily dosing combination was acceptable.
    Pre-assignment Detail After providing informed consent potential participants were screened, and after eligibility was confirmed, participants were stabilized on 6 mg daily of oral risperidone (3 mg administered twice a day [BID] approximately 12 hours apart) for 5 days. After completion of the stabilization period, participants were eligible to receive 180 mg PERSERIS (subcutaneous risperidone), administered as two 90 mg SC injections every 28 days.
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Period Title: Overall Study
    STARTED 69
    Stabilization Period 25
    Treatment Period 23
    COMPLETED 15
    NOT COMPLETED 54

    Baseline Characteristics

    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Overall Participants 23
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    53.3
    (10.98)
    Sex: Female, Male (Count of Participants)
    Female
    9
    39.1%
    Male
    14
    60.9%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    3
    13%
    Not Hispanic or Latino
    20
    87%
    Unknown or Not Reported
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    Asian
    1
    4.3%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    Black or African American
    17
    73.9%
    White
    5
    21.7%
    More than one race
    0
    0%
    Unknown or Not Reported
    0
    0%
    Body Mass Index (kg/m^2) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [kg/m^2]
    28.49
    (4.650)
    CYP2D6 Genotype (Count of Participants)
    Poor
    0
    0%
    Intermediate
    0
    0%
    Extensive
    23
    100%
    Ultra-rapid
    0
    0%

    Outcome Measures

    1. Primary Outcome
    Title Steady-state Average Plasma Concentration (Cavg,ss) of Risperidone and Total Active Moiety
    Description Cavg,ss for risperidone and total active moiety after oral and SC administration
    Time Frame 0-12 hours post-dose on Day -1, and 0-672 hours after Dose 3

    Outcome Measure Data

    Analysis Population Description
    The primary PK analysis was conducted in participants who received at least 3 doses of PERSERIS 180 mg and provided adequate blood samples for the determination of Cavg after the third dose (primary PK population).
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 16
    Risperidone after oral dosing
    5.150
    (43.3)
    Risperidone after Dose 3
    10.200
    (65.3)
    Total active moiety after oral dosing
    43.730
    (34.8)
    Total active moiety after Dose 3
    44.049
    (24.4)
    2. Secondary Outcome
    Title Assessment of Local Injection Site Tolerability*
    Description Injection site tolerability was measured by injection site grading for redness, induration, swelling and tenderness/pain. These were graded on a scale from 0 to 4 for severity (none, mild, moderate, severe and potentially life-threatening)
    Time Frame First injection at Day 1 until last injection administered at Day 85

    Outcome Measure Data

    Analysis Population Description
    The number of participants assessed is the actual number who received the injection at each visit. *By the nature of this outcome measure (injection site), all results are reported for participants who had received PERSERIS
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    None
    22
    95.7%
    Mild
    1
    4.3%
    None
    19
    82.6%
    Mild
    1
    4.3%
    None
    16
    69.6%
    Mild
    0
    0%
    None
    15
    65.2%
    Mild
    1
    4.3%
    None
    21
    91.3%
    Mild
    2
    8.7%
    None
    18
    78.3%
    Mild
    2
    8.7%
    None
    15
    65.2%
    Mild
    1
    4.3%
    None
    13
    56.5%
    Mild
    3
    13%
    None
    22
    95.7%
    Mild
    1
    4.3%
    None
    20
    87%
    Mild
    0
    0%
    None
    16
    69.6%
    Mild
    0
    0%
    None
    16
    69.6%
    Mild
    0
    0%
    None
    23
    100%
    Mild
    0
    0%
    None
    20
    87%
    Mild
    0
    0%
    None
    15
    65.2%
    Mild
    1
    4.3%
    None
    14
    60.9%
    Mild
    2
    8.7%
    3. Secondary Outcome
    Title The Number of Participants With TEAEs as Assessed by Local Injection Site*
    Description The injection site was evaluated for adverse events by observation and examination by appropriately trained personnel.
    Time Frame First injection at Day 1 until Day 120

    Outcome Measure Data

    Analysis Population Description
    *By the nature of this outcome measure (injection site), all results are reported for participants who had received PERSERIS
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Count of Participants [Participants]
    1
    4.3%
    4. Secondary Outcome
    Title The Number of Participants With TEAEs as Assessed by Changes in Vital Signs
    Description Vital sign measurement was performed, including orthostatic blood pressure, and clinically significant changes were reported as adverse events (AE). Vital sign measurement also included measurement of pulse rate, oral temperature and respiratory rate. Determination of whether the changes were AEs was made by the investigator or a medically qualified designee. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range and the subject was clinically stable, a specific diagnosis was established, or the condition otherwise explained.
    Time Frame Time subjects sign the informed consent form throughout the study until EOS (Day 113)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Count of Participants [Participants]
    1
    4.3%
    5. Secondary Outcome
    Title The Number of Participants With TEAEs as Assessed by Changes in ECG
    Description ECGs were performed, and clinically significant changes in parameters were reported as adverse events (AE). ECGs were performed after 5 minutes of rest, and ECG parameters including QT interval, PR interval, QRS interval and heart rate was recorded. The ECG measurements were evaluated during the visit and determination of whether any abnormalities were AEs was made by the investigator or a medically qualified designee. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range and the subject was clinically stable, a specific diagnosis was established, or the condition otherwise explained.
    Time Frame Time participants sign the informed consent form throughout the study until EOS (Day 113)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Count of Participants [Participants]
    0
    0%
    6. Secondary Outcome
    Title The Number of Participants With TEAEs as Assessed by Changes in Body Weight
    Description Body weight, with shoes off, was measured and clinically significant changes in weight was reported as adverse events (AE). Determination of whether the changes were AEs was made by the investigator or a medically qualified designee. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range and the subject was clinically stable, a specific diagnosis was established, or the condition otherwise explained.
    Time Frame Time subjects sign the informed consent form throughout the study until EOS (Day 113)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Count of Participants [Participants]
    1
    4.3%
    7. Secondary Outcome
    Title The Number of Participants With TEAEs as Assessed by Changes in Laboratory Testing
    Description Laboratory testing was performed by the local clinical laboratory accredited by the College of American Pathologists, and clinically significant changes from baseline were reported as AEs. Subjects were expected to fast for a minimum of 8 hours prior to blood draws for all laboratory assessments except at the screening visit. Prior to entering the study, any abnormal laboratory test results were to be considered not clinically significant. Any abnormal hematology, serum chemistry or urinalysis test result after study drug intake that was determined by the investigator or a medically qualified designee to be clinically significant was reported as an AE. If determined to be an AE, the measurement was repeated at appropriate intervals until the value returned to an acceptable range or it was determined that resolution was not expected.
    Time Frame Time subjects sign the informed consent form throughout the study until end of study (EOS) visit (Day 113)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Count of Participants [Participants]
    3
    13%
    8. Secondary Outcome
    Title The Number of Participants With TEAEs as Assessed by Extrapyramidal Symptoms (EPS) of Anti-psychotic Drug Treatment
    Description Safety of treatment was measured by administration of symptom questionnaires including AIMS, Barnes Akathisia Rating Scale (BARS) and Simpson-Angus Scale (SAS), as well as by assessment by the investigator or suitably qualified medical designee. The AIMS is a tool that aids in early detection and ongoing monitoring of tardive dyskinesia, a movement disorder. The BARS is a 4-item scale that detects the presence and severity of any drug-induced restlessness. The SAS is a 10-item scale used to detect the presence of drug-induced Parkinsonism (movement disorder seen in Parkinson's disease) and extrapyramidal side effects and evaluates symptom severity. Extrapyramidal symptoms include involuntary or uncontrollable movements, tremors, and muscle contractions.
    Time Frame Time subjects sign the informed consent form throughout the study until EOS (Day 113)

    Outcome Measure Data

    Analysis Population Description
    There were no clinically important differences in mean scores across study visits. TEAEs related to EPS are reported below
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Akathisia
    1
    4.3%
    Dyskinesia
    2
    8.7%
    Parkinsonian gait
    1
    4.3%
    Tremor
    1
    4.3%
    9. Secondary Outcome
    Title Positive and Negative Syndrome Scale (PANSS)
    Description Clinical outcome (efficacy endpoint) as measured by change from baseline in PANSS scores was measured. PANSS is a medical scale designed to measure schizophrenia symptom severity utilizing a 30 item, 7-point rating scheme. The PANSS Is scored by a summation of ratings across items, with a total potential range of 7-210; higher results indicate greater severity of illness. Only total score changes from baseline are reported here.
    Time Frame Baseline, defined as last assessment prior to first injection, through Day 113 (EOS)

    Outcome Measure Data

    Analysis Population Description
    PANSS total scores change from baseline measure from baseline through Day 113 for those participants with results reported
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Total score change from baseline: Dose 1 Day 2
    -0.2
    (3.52)
    Total score change from baseline: Dose 1 Day 8
    0.9
    (3.91)
    Total score change from baseline: Dose 1 Day 15
    0.7
    (4.81)
    Total score change from baseline: Dose 1 Day 22
    -0.4
    (4.16)
    Total score change from baseline: Dose 2 Day 29
    -0.9
    (5.05)
    Total score change from baseline: Dose 2 Day 50
    -0.5
    (7.21)
    Total score change from baseline: Dose 3 Day 57
    -2.9
    (4.92)
    Total score change from baseline: Dose 4 Day 85
    -0.9
    (6.00)
    Total score change from baseline: Day 113-EOS
    1.6
    (6.22)
    10. Secondary Outcome
    Title Clinical Global Impression-Severity of Illness Scale (CGI-S)
    Description Clinical outcome (efficacy endpoint) as measured by change from baseline in CGI-S scores was measured. The CGI-S is a measurement of the total severity of illness where one question is assessed. Responses range from 0 (not assessed) to 7 (most extremely ill).
    Time Frame Baseline through EOS (Day 113)

    Outcome Measure Data

    Analysis Population Description
    Severity of illness observed values were measured and change from baseline calculated for those participants with results reported.
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Change from baseline: Dose 1/Day 2
    -0.1
    (0.29)
    Change from baseline: Dose 1/Day 8
    0.0
    (0.21)
    Change from baseline: Dose 1/Day 15
    0.0
    (0.38)
    Change from baseline: Dose 1/Day 22
    0.0
    (0.44)
    Change from baseline: Dose 2/Day 29
    0.0
    (0.44)
    Change from baseline: Dose 2/Day 50
    0.0
    (0.47)
    Change from baseline: Dose 3/Day 57
    0.1
    (0.44)
    Change from baseline: Dose 4/Day 85
    0.1
    (0.50)
    Change from baseline: EOS/Day 113
    0.0
    (0.55)
    11. Secondary Outcome
    Title Columbia-Suicide Severity Rating Scale (C-SSRS)-Change
    Description Significant changes from baseline in C-SSRS scores were reported as adverse events. The C-SSRS is based on a categorization of thoughts and behavior that are identified as related to suicidal behavior. The scale captures the occurrence, severity and frequency of suicide related thoughts and behaviors throughout lifetime at screening and for the time interval since last administration during a study. Responses are indicated as yes (thought or behavior did occur) or no (thought or behavior did not occur). If a yes response is received, then follow up questions are asked. The outcome of the C-SSRS is a numerical score obtained from each of the categories. Scores can range from 0-25, indicating the intensity rating, and any score greater than 0 may indicate the need for mental health intervention. Higher scores indicate greater intensity (i.e. worse outcome).
    Time Frame Screening through EOS (Day 113)

    Outcome Measure Data

    Analysis Population Description
    Only actual number of participants assessed at visit was reported. Only change in suicidal behavior from baseline at Dose 1/Day 8 (first measure after baseline) and EOS is reported as all numbers are zero.
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    Change in Maximum Suicidal Ideation at Dose 1/Day 8
    0.0
    (0.00)
    Change in Maximum Suicidal Ideation at EOS
    0.0
    (0.00)
    Change in Suicidal Ideation Intensity Score at Dose 1/Day 8
    0.0
    (0.00)
    Change in Suicidal Ideation Intensity Score at EOS
    0.0
    (0.00)
    Change in Maximum Suicidal Behavior at Dose 1/Day 8
    0.0
    (0.00)
    Change in Maximum Suicidal Behavior at EOS
    0.0
    (0.00)
    12. Secondary Outcome
    Title Safety as Measured by Columbia-Suicide Severity Rating Scale (C-SSRS) Scores
    Description Safety of treatment was measured by characterization of thoughts and behavior related to suicidal behavior. This was assessed by administration of the C-SSRS at designated visits. The scale captures the occurrence, severity and frequency of suicide related thoughts and behaviours throughout lifetime at screening and for the time interval since last administration during a study. Questions solicit the type of information needed to determine if a suicide-related thought or behavior occurred.
    Time Frame Screening through EOS (Day 113)

    Outcome Measure Data

    Analysis Population Description
    Only actual number of participants assessed at visit was reported. Only results for lifetime, past 6 months and EOS are reported as all responses are 'no' after lifetime.
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 23
    No
    15
    65.2%
    Yes
    8
    34.8%
    No
    23
    100%
    Yes
    0
    0%
    No
    14
    60.9%
    Yes
    0
    0%
    No
    17
    73.9%
    Yes
    6
    26.1%
    No
    20
    87%
    Yes
    0
    0%
    No
    14
    60.9%
    Yes
    0
    0%
    No
    15
    65.2%
    Yes
    8
    34.8%
    No
    20
    87%
    Yes
    0
    0%
    No
    14
    60.9%
    Yes
    0
    0%
    13. Secondary Outcome
    Title Minimum Plasma Concentration Over the Dosing Interval
    Description Minimum observed plasma concentration of risperidone, 9-hydroxyrisperidone (9-OH) and total active moiety over the dosing interval after oral dosing and SC doses 1, 3 and 4
    Time Frame Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).

    Outcome Measure Data

    Analysis Population Description
    PK population. Actual number of participants analyzed for each period is reported
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 24
    Risperidone after oral dosing
    1.066
    (89.0)
    Risperidone after Dose 1
    3.017
    (39.0)
    Risperidone after Dose 3
    4.519
    (48.1)
    Risperidone after Dose 4
    5.020
    (48.7)
    9-OH after oral dosing
    27.705
    (41.7)
    9-OH after Dose 1
    13.922
    (63.6)
    9-OH after Dose 3
    16.951
    (41.6)
    9-OH after Dose 4
    14.820
    (46.3)
    Total active moiety after oral dosing
    28.329
    (39.6)
    Total active moiety after Dose 1
    17.852
    (55.8)
    Total active moiety after Dose 3
    22.250
    (37.7)
    Total active moiety after Dose 4
    22.063
    (35.7)
    14. Secondary Outcome
    Title Maximum Plasma Concentration Over the Dosing Interval
    Description Maximum observed plasma concentration of risperidone, 9-hydroxyrisperidone (9-OH) and total active moiety over the dosing interval after oral dosing and SC doses 1, 3 and 4
    Time Frame Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4)

    Outcome Measure Data

    Analysis Population Description
    Analysis population is the PK population. Actual number of participants analyzed for each period is reported.
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 24
    Risperidone after oral dosing
    14.052
    (45.2)
    Risperidone after Dose 1
    16.743
    (57.1)
    Risperidone after Dose 3
    18.635
    (54.6)
    Risperidone after Dose 4
    29.821
    (65.1)
    9-OH after oral dosing
    45.464
    (40.0)
    9-OH after Dose 1
    45.285
    (43.3)
    9-OH after Dose 3
    56.476
    (34.5)
    9-OH after Dose 4
    52.240
    (27.4)
    Total active moiety after oral dosing
    58.453
    (33.5)
    Total active moiety after Dose 1
    58.317
    (38.4)
    Total active moiety after Dose 3
    70.597
    (30.7)
    Total active moiety after Dose 4
    77.219
    (32.5)
    15. Secondary Outcome
    Title Percent Fluctuation in Concentration Over the Dosing Interval
    Description Plasma concentration variation of risperidone, 9-OH and total active moiety over the dosing interval was measured by percent fluctuation after oral dosing and SC doses 1, 3 and 4 at steady state.
    Time Frame Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4)

    Outcome Measure Data

    Analysis Population Description
    PK population. Actual number of participants analyzed for each period is reported
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 24
    Risperidone after oral dosing
    253.335
    (33.6)
    Risperidone after Dose 1
    174.653
    (35.4)
    Risperidone after Dose 3
    135.267
    (19.6)
    Risperidone after Dose 4
    190.117
    (66.7)
    9-OH after oral dosing
    46.787
    (32.0)
    9-OH after Dose 1
    115.645
    (48.1)
    9-OH after Dose 3
    115.286
    (55.5)
    9-OH after Dose 4
    116.852
    (44.7)
    Total active moiety after oral dosing
    71.468
    (26.0)
    Total active moiety after Dose 1
    115.113
    (29.2)
    Total active moiety after Dose 3
    106.210
    (28.6)
    Total active moiety after Dose 4
    118.435
    (34.5)
    16. Secondary Outcome
    Title Area Under the Plasma Concentration-time Curve Over the Dosing Interval
    Description Area under the plasma concentration-time curve (AUC) was measured for risperidone, 9-OH and total active moiety.
    Time Frame Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).

    Outcome Measure Data

    Analysis Population Description
    PK population; actual number of participants analyzed for each period is reported
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 24
    Risperidone after oral dosing
    60.354
    (54.4)
    Risperidone after Dose 1
    5021.191
    (55.0)
    Risperidone after Dose 3
    6854.855
    (65.2)
    Risperidone after Dose 4
    7762.268
    (63.6)
    9-OH after oral dosing
    432.801
    (38.4)
    9-OH after Dose 1
    17615.97
    (44.0)
    9-OH after Dose 3
    22203.31
    (28.9)
    9-OH after Dose 4
    20527.19
    (30.2)
    Total active moiety after oral dosing
    489.888
    (34.0)
    Total active moiety after Dose 1
    22955.74
    (37.5)
    Total active moiety after Dose 3
    29602.72
    (24.4)
    Total active moiety after Dose 4
    29217.83
    (23.4)
    17. Secondary Outcome
    Title Average Plasma Concentration (Cavg) Over the Dosing Interval of Risperidone, 9-OH and Total Active Moiety
    Description Average plasma concentration of risperidone, 9-hydroxyrisperidone (9-OH) and total active moiety over the dosing interval after oral dosing and SC doses 1, 3 and 4.
    Time Frame Calculated over the dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).

    Outcome Measure Data

    Analysis Population Description
    PK population; actual number of participants analyzed for each period is reported
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 24
    Risperidone after oral dosing
    5.030
    (54.4)
    Risperidone after Dose 1
    7.454
    (55.2)
    Risperidone after Dose 3
    10.200
    (65.3)
    Risperidone after Dose 4
    11.618
    (63.2)
    9-OH after oral dosing
    36.066
    (38.4)
    9-OH after Dose 1
    26.148
    (44.0)
    9-OH after Dose 3
    33.039
    (28.8)
    9-OH after Dose 4
    30.723
    (31.3)
    Total active moiety after oral dosing
    40.823
    (34.0)
    Total active moiety after Dose 1
    34.077
    (37.5)
    Total active moiety after Dose 3
    44.049
    (24.4)
    Total active moiety after Dose 4
    43.729
    (24.0)
    18. Secondary Outcome
    Title Trough Plasma Concentration
    Description Trough (pre-dose) plasma concentrations were measured for risperidone, 9-OH and total active moiety for SC doses 1, 3 and 4
    Time Frame Calculated over the dosing interval (0-672 hours) after Dose 1, 3 or 4.

    Outcome Measure Data

    Analysis Population Description
    PK population; actual number of participants analyzed for each period is reported.
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 24
    Risperidone after Dose 1
    1.766
    (117.9)
    Risperidone after dose 3
    5.066
    (48.0)
    Risperidone after Dose 4
    4.966
    (62.9)
    9-OH after dose 1
    33.696
    (37.9)
    9-OH after dose 3
    20.326
    (51.0)
    9-OH after dose 4
    17.983
    (39.2)
    Total active moiety after dose 1
    35.553
    (35.6)
    Total active moiety after dose 3
    25.468
    (43.0)
    Total active moiety after dose 4
    23.125
    (37.3)
    19. Secondary Outcome
    Title Time to Occurrence of Maximum Concentration
    Description Time to maximal observed plasma concentration (Tmax) for risperidone, 9-OH, and total active moiety after oral dosing and SC doses 1, 3 and 4.
    Time Frame Calculated over the overall dosing interval (0-12 hours on Day -1, or 0-672 hours after Dose 1, 3 or 4).

    Outcome Measure Data

    Analysis Population Description
    PK population; actual number of participants analyzed for each period is reported
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS (subcutaneous risperidone) is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone
    Measure Participants 24
    Risperidone after oral dosing
    1.0
    Risperidone after Dose 1
    240.175
    Risperidone after Dose 3
    143.865
    Risperidone after Dose 4
    12.050
    9-OH after oral dosing
    1.990
    9-OH after Dose 1
    204.515
    9-OH after Dose 3
    182.535
    9-OH after Dose 4
    118.120
    Total active moiety after oral dosing
    1.010
    Total active moiety after Dose 1
    239.665
    Total active moiety after Dose 3
    182.535
    Total active moiety after Dose 4
    192.100

    Adverse Events

    Time Frame Adverse event data was collected from the time of informed consent through the end of study for each subject, Day 120, a total of up to 146 days including the screening and dosing stabilization periods.
    Adverse Event Reporting Description Adverse events (AE) were collected through a combination of systemic and non-systemic methods. AEs were collected through self-reporting by participants, and systemic methods included scheduled laboratory testing, investigator assessments of disease severity through PANSS, CGI-S and other scales, injection site assessments, ECGs, pregnancy testing for women of child-bearing potential. The one serious AE and all AEs above the frequency reporting threshold occurred in subjects receiving PERSERIS
    Arm/Group Title Oral Risperidone Followed by PERSERIS
    Arm/Group Description All participants received up to 4 monthly doses of 180 mg PERSERIS (each 180 mg dose was administered as two 90 mg SC injections). The first 3 monthly doses were administered in the abdominal region while the fourth monthly dose was administered in the back of the upper arm. PERSERIS: PERSERIS is an extended-release SC injectable suspension administered once-monthly Risperidone: Oral risperidone Outcome measures and adverse events were not reported by intervention, but by number of participants who experienced the adverse event. Based on narrative, it was possible to determine the timing of the serious adverse event. By nature of the adverse event, any injection site reported adverse events or outcome data occurred in participants who had received PERSERIS
    All Cause Mortality
    Oral Risperidone Followed by PERSERIS
    Affected / at Risk (%) # Events
    Total 0/23 (0%)
    Serious Adverse Events
    Oral Risperidone Followed by PERSERIS
    Affected / at Risk (%) # Events
    Total 1/23 (4.3%)
    Hepatobiliary disorders
    increase in liver enzymes 1/23 (4.3%) 1
    Other (Not Including Serious) Adverse Events
    Oral Risperidone Followed by PERSERIS
    Affected / at Risk (%) # Events
    Total 9/23 (39.1%)
    Infections and infestations
    upper respiratory tract infection 3/23 (13%) 3
    Injury, poisoning and procedural complications
    fall 2/23 (8.7%) 2
    Investigations
    blood prolactin increased 2/23 (8.7%) 2
    Metabolism and nutrition disorders
    decreased appetite 2/23 (8.7%) 2
    Nervous system disorders
    dyskinesia 2/23 (8.7%) 2
    headache 2/23 (8.7%) 2

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The Principal Investigator and Institution may have access to the Case Report Forms resulting solely from their participation in the study for purely scientific or educational purposes, but unless previously explicitly permitted in writing by the Sponsor, Principal Investigator and Institution may not use it for any publication, presentation, disclosure, or commercial purposes.

    Results Point of Contact

    Name/Title PERSERIS Medicines Development Lead and Head Global Clinical Operations and Development
    Organization Indivior Inc
    Phone 804 379-1090
    Email regan.fong@indivior.com
    Responsible Party:
    Indivior Inc.
    ClinicalTrials.gov Identifier:
    NCT03978832
    Other Study ID Numbers:
    • INDV-7000-401
    First Posted:
    Jun 7, 2019
    Last Update Posted:
    Jul 7, 2021
    Last Verified:
    Jun 1, 2021