ZENITH: Safety and Tolerability Study of Oral OPC-34712 as Maintenance Treatment in Adults With Schizophrenia

Sponsor
Otsuka Pharmaceutical Development & Commercialization, Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT01397786
Collaborator
(none)
1,044
148
1
52
7.1
0.1

Study Details

Study Description

Brief Summary

The purpose of this study is to assess the long-term safety, tolerability and efficacy of oral OPC-34712 as monotherapy in adults with schizophrenia.

Condition or Disease Intervention/Treatment Phase
Phase 3

Detailed Description

Schizophrenia is a severely debilitating mental illness that affects approximately 1% of the world population. Hallucinations and delusions are the most striking characteristic positive symptoms of schizophrenia; however, more subtle negative symptoms (eg, social withdrawal and lack of emotion, energy, and motivation) may also be present. The first antipsychotics developed for the treatment of schizophrenia were effective against positive symptoms, but showed little efficacy for negative symptoms and were also associated with a high incidence of side effects. Second generation antipsychotics, represent a significant advancement in the treatment of psychotic disorders because they are effective and at the same time exhibit fewer side effects than first generation antipsychotics. Although generally safer than first generation antipsychotics, the second-generation antipsychotics are not devoid of undesirable side effects such as Hyperprolactinemia and weight gain. In addition, the safety of these drugs vary considerably.

Study Design

Study Type:
Interventional
Actual Enrollment :
1044 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Long-term, Phase 3, Multicenter, Open-label Trial to Evaluate the Safety and Tolerability of Oral OPC-34712 as Maintenance Treatment in Adults With Schizophrenia
Study Start Date :
Sep 1, 2011
Actual Primary Completion Date :
Jan 1, 2016
Actual Study Completion Date :
Jan 1, 2016

Arms and Interventions

Arm Intervention/Treatment
Experimental: OPC-34712

Drug: OPC-34712
Phase A: 1-2 mgs/day by mouth, max of 4 wks. Phase B: 1-4 mgs/day by mouth, up to 52 weeks

Outcome Measures

Primary Outcome Measures

  1. Percentage of Participants With Adverse Events (AEs) [From Baseline up to 52 Weeks]

    A treatment-emergent adverse event (TEAE) is defined as an AE that started after start of investigational medicinal product (IMP) treatment; or if the event was continuous from baseline and was serious, IMP-related, or resulted in death, discontinuation, interruption or reduction of IMP.

Secondary Outcome Measures

  1. Mean Change From Baseline in Positive and Negative Syndrome Scale Total Score [From Baseline up to 52 Weeks]

    The PANSS consisted of 3 subscales with 30 symptom constructs (positive subscale (7): delusions, conceptual disorganization, hallucinatory behavior, excitement, grandiosity, suspiciousness/perseckion, and hostility; negative subscale (7): blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity and conversation flow, stereotyped thinking and general psychopathology subscale (16): somatic concern, anxiety, guilt feelings, tension, mannerisms and posturing, depression, motor retardation, uncooperativeness, unusual thought content, disorientation, poor attention, lack of judgment and insight, disturbance of volition, poor impulse control, preoccupation, and active social avoidance). Severity was rated on 7-point scale with scores 1 (absence) & 7 (extremely severe). The PANSS total score was sum of rating scores for 7 positive, 7 negative, and 16 general psychopathology subscale items of PANSS panel.

  2. Mean Change From Baseline in PANSS Positive Subscale Score [From Baseline up to 52 Weeks]

    The PANSS consisted of three subscales that contained a total of 30 symptom constructs. For each symptom construct, severity is rated on a 7-point scale, with a score of 1 indicated the absence of symptoms and a score of 7 indicated extremely severe symptoms. In positive subscale, the 7 positive symptom constructs were: delusions, conceptual disorganization, hallucinatory behavior, excitement, grandiosity, suspiciousness/persecution, and hostility.

  3. Mean Change From Baseline in PANSS Negative Subscale Score [From Baseline up to 52 Weeks]

    The PANSS consisted of three subscales that contained a total of 30 symptom constructs. For each symptom construct, severity was rated on a 7-point scale, with a score of 1 indicated the absence of symptoms and a score of 7 indicated extremely severe symptoms. In negative subscale the severity was rated for the following 7 negative symptom constructs: blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation, stereotyped thinking.

  4. Mean Change From Baseline in Clinical Global Impression - Severity of Illness Scale Score [From Baseline up to 52 Weeks]

    The severity of illness for each participant was rated using the CGI-S. To perform this assessment, the investigator were to answer the following question: "Considering your total clinical experience with this particular population, how mentally ill was the participant at that time?" Response choices include: 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; and 7 = among the most extremely ill participants.

  5. Mean Change From Baseline in Personal and Social Performance Scale Total Score [From Baseline up to 52 Weeks]

    The PSP was a validated clinician-rated scale that measured personal and social functioning in four domains: socially useful activities (e.g, work and study), personal and social relationships, self-care, and disturbing and aggressive behaviors. Impairment in each of these domains was rated as absent, mild, manifest, marked, severe, or very severe. These ratings were then converted to a total score based on a 100-point scale using algorithms to identify the appropriate 10-point interval, and the rater's judgment that determined the total score within the 10-point interval. Participants with a PSP total score of 71 to 100 were considered to have mild functional difficulty. Scores of 31 to 70 represented manifest disabilities of various degrees and ratings of 1 to 30 indicated minimal functioning that required intense support and/or supervision.

  6. Mean Clinical Global Impression - Improvement Score [From Baseline up to 52 Weeks]

    The efficacy of study medication was rated for each participant using the CGI-I. The investigator rated the participant's total improvement whether or not it was due to the drug treatment. All responses were compared to the participant's condition at Screening/Baseline (i.e, Week 6 visit of Protocol NCT00905307). Response choices included: 0 = not assessed, 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse.

  7. Response Rate [From Baseline up to 52 Weeks]

    Response rate was defined as a reduction of ≥ 30% from Baseline in PANSS total score or CGI-I score of 1 (very much improved) or 2 (much improved) at the Last Visit.

  8. Discontinuation Rate for Lack of Efficacy [From Baseline up to 52 Weeks]

    Discontinuation rate for the participants who discontinued due to lack of efficacy were examined.

  9. Mean Change From Baseline in Positive and Negative Syndrome Scale Excited Component Score [From Baseline up to 52 Weeks]

    The PEC score consisted of five PANSS items: excitement (P4), hostility (P7), tension (G4), uncooperativeness (G8), and poor impulse control (G14). Each of the items were rated on a scale of 1 (absent) to 7 (extreme). The PEC scores ranged from 5 (not present) to 35 (extremely severe).

  10. Mean Change From Baseline in PANSS Marder Factor Scores - Positive Symptoms Score [From Baseline up to 52 Weeks]

    Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The positive factor score was the sum of the 8 components (delusions (P1), hallucinatory behavior (P3), grandiosity (P5), suspiciousness/persecution (P6), stereotyped thinking (N7), somatic concern (G1), unusual thought content (G9) and lack of judgment and insight (G12)) of the positive symptoms scale (range: 8 - best possible outcome to 56 - worst possible outcome).

  11. Mean Change From Baseline in PANSS Marder Factor Scores - Negative Symptoms Score [From Baseline up to 52 Weeks]

    Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The negative factor score is the sum of the 7 items (blunted affect (N1), emotional withdrawal (N2), poor rapport (N3), passive/apathetic social withdrawal (N4), lack of spontaneity and conversation flow (N6), motor retardation (G7) and active social avoidance (G16)) of the negative subscale (range: 8 - best possible outcome to 56 - worst possible outcome).

  12. Mean Change From Baseline in PANSS Marder Factor Scores - Disorganized Thought Score [From Baseline up to 52 Weeks]

    Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The disorganized thoughts factor score is the sum of score from the 7 items (conceptual disorganization (P2), difficulty in abstract thinking (N5), mannerisms and posturing (G5), disorientation (G10), poor attention (G11), disturbance of volition (G13) and preoccupation (G15)) on the disorganized thoughts subscale (range: 7 - best possible outcome to 49 - worst possible outcome).

  13. Mean Change From Baseline in PANSS Marder Factor Scores - Hostility/ Excitement Score [From Baseline up to 52 Weeks]

    Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The uncontrolled hostility/excitement factor score is the sum of score from the 4 items (excitement (P4), hostility (P7), uncooperativeness (G8) and poor impulse control (G14)) on the uncontrolled hostility/excitement subscale (range: 4 - best possible outcome to 28 - worst possible outcome).

  14. Mean Change From Baseline in PANSS Marder Factor Scores - Anxiety/Depression Score [From Baseline up to 52 Weeks]

    Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The anxiety/depression factor score is the sum of score from the 4 items (anxiety (G2), guilt feelings (G3), tension (G4) and depression (G6)) on the anxiety/depression subscale (range: 4 - best possible outcome to 28 - worst possible outcome).

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 65 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  1. Male or female subjects between 18 and 65 years of age, with a diagnosis of schizophrenia, as defined by DSM-IV-TR criteria

  2. Outpatient status at last visit of Trial 331-10-230 or Trial 331-10-231

  3. Willing to discontinue all prohibitive psychotropic medications to meet protocol required washouts prior to and during the trial period.

  4. Other protocol specific inclusion criteria may apply.

Exclusion Criteria:
  1. Females who are breast-feeding and/or who have a positive pregnancy test result prior to receiving study drug

  2. Subjects with a current DSM-IV-TR Axis I diagnosis of:

  • Schizoaffective disorder

  • MDD

  • Bipolar disorder

  • Delirium, dementia, amnestic or other cognitive disorder

  • Borderline, paranoid, histrionic, schizotypal, schizoid or antisocial personality disorder

  1. Subjects presenting with a first episode of schizophrenia

  2. Other protocol specific exclusion criteria may apply.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Birmingham Alabama United States 35226
2 Little Rock Arkansas United States 72201
3 Little Rock Arkansas United States 72205
4 Springdale Arkansas United States 72764
5 Anaheim California United States 92805
6 Cerritos California United States 90703
7 Escondido California United States 92025
8 Garden Grove California United States 92845
9 Glendale California United States 91206
10 Long Beach California United States 90813
11 National City California United States 91950
12 Oakland California United States 94612
13 Oceanside California United States 92056
14 Pico Rivera California United States 90660
15 San Diego California United States 92102
16 San Diego California United States 92103
17 San Diego California United States 92123
18 Torrance California United States 90502
19 Washington District of Columbia United States 20016
20 Bradenton Florida United States 34208
21 LeesBurg Florida United States 34748
22 Maitland Florida United States 32751
23 Miami Springs Florida United States 33166
24 Miami Florida United States 33143
25 North Miami Florida United States 33162
26 Tampa Florida United States 33613
27 Chicago Illinois United States 60611
28 Hoffman Estates Illinois United States 60169
29 Joliet Illinois United States 60435
30 Oak Brook Illinois United States 60523
31 Overland Park Kansas United States 66212
32 Lake Charles Louisiana United States 70629
33 Shreveport Louisiana United States 71104
34 Flowood Mississippi United States 39232
35 St. Charles Missouri United States 63301
36 St. Louis Missouri United States 63109
37 St. Louis Missouri United States 63141
38 Las Vegas Nevada United States 89102
39 Buffalo New York United States 14215
40 Cedarhurst New York United States 11516
41 Jamaica New York United States 11432
42 Rochester New York United States 14618
43 Staten Island New York United States 10305
44 Staten Island New York United States 10312
45 Dayton Ohio United States 45417
46 Allentown Pennsylvania United States 18104
47 Norristown Pennsylvania United States 19403
48 Charleston South Carolina United States 29407
49 Memphis Tennessee United States 38119
50 Austin Texas United States 78731
51 Austin Texas United States 78754
52 Dallas Texas United States 75231
53 Dallas Texas United States 75243
54 Houston Texas United States 77007
55 Richmond Virginia United States 23230
56 Kirkland Washington United States 98033
57 Burlington Ontario Canada L7R 4E2
58 Chatham Ontario Canada N7M 5L9
59 Barranquilla Colombia 00000
60 Bello Colombia 00000
61 Bogota Colombia 00000
62 Pereira Colombia 00000
63 Rijeka Croatia 51000
64 Zagreb Croatia 10090
65 Fujisawa-shi Kanagawa-Ken Japan 251-8530
66 Kumamoto-shi Kumamoto-Ken Japan 861-8002
67 Kunigami-gun Okinawa-Ken Japan 904-1201
68 Sakai-shi Osaka-Fu Japan 590-0018
69 Incheon Korea, Republic of 400-711
70 Incheon Korea, Republic of 405-760
71 Seoul Korea, Republic of 136-705
72 Seoul Korea, Republic of 137-710
73 Seoul Korea, Republic of 143-711
74 Daugavpils Latvia LV-5417
75 Jelgava Latvia LV-3008
76 Liepaja Latvia LV-3401
77 Riga Latvia LV-1005
78 Strenci Latvia LV-4730
79 Kota Bahru Kelantan Malaysia 15586
80 Kajang Selangor Malaysia 43000
81 Ipoh Malaysia 31250
82 Jalan Greentown Malaysia 30450
83 Kuala Lumpur Malaysia 59100
84 Sabah Malaysia 88815
85 Col. Florida Distrito Federal Mexico 01030
86 Monterrey Nuevo Leon Mexico 64060
87 San Luis Potosi San Luis Potos Mexico 78218
88 Cebu City Philippines 6000
89 Davao City Philippines 8000
90 Manila Philippines 1000
91 Choroszcz Poland 16-070
92 Gdansk Poland 80-282
93 Gdansk Poland 80-952
94 Lodz Poland 91-229
95 San Juan Puerto Rico 00918
96 San Juan Puerto Rico 00927
97 Arad Romania 310022
98 Brasov Romania 500123
99 Bucuresti Romania 010825
100 Bucuresti Romania 030442
101 Bucuresti Romania 041914
102 Cluj-Napoca Romania 400012
103 Craiova Romania 200473
104 Focsani Romania 620165
105 Iasi Romania 700282
106 Pitesti Romania 110069
107 Targoviste Romania 130086
108 Arkhangelsk Russian Federation 163530
109 Moscow Region Russian Federation 142601
110 Moscow Russian Federation 117152
111 Moscow Russian Federation 119435
112 Nizhniy Novgorod Russian Federation 603155
113 Petrozavodsk Russian Federation 185000
114 Samara Russian Federation 443016
115 Saratov Russian Federation 410060
116 St. Petersburg Russian Federation 190005
117 St. Petersburg Russian Federation 190121
118 St. Petersburg Russian Federation 192019
119 St. Petersburg Russian Federation 194214
120 St. Petersburg Russian Federation 197341
121 Tomsk Russian Federation 634014
122 Village Nikolskoe Russian Federation 188357
123 Belgrade Serbia 11000
124 Kragujevac Serbia 34000
125 Novi Knezevac Serbia 23330
126 Novi Sad Serbia 21000
127 Bratislava Slovakia 82606
128 Michalovce Slovakia 07101
129 Rimavska Sobota Slovakia 97912
130 Roznava Slovakia 04801
131 Kashsiung Taiwan 802
132 New Taipei City Taiwan 249
133 Taipei Taiwan 110
134 Taoyuan County Taiwan 333
135 Diyarbakir Turkey 21280
136 Kocaeli Turkey 41380
137 Chernihiv Ukraine 14000
138 Dnipropetrovsk Ukraine 49027
139 Dnipropetrovsk Ukraine 49115
140 Glevakha Ukraine 08631
141 Kharkiv Ukraine 61068
142 Kherson, Vil. Stepanivka Ukraine 73488
143 Kyiv Ukraine 02660
144 Kyiv Ukraine 04080
145 Lviv Ukraine 79021
146 Odesa Ukraine 65014
147 Simferopol Ukraine 95006
148 Vinnytsia Ukraine 21005

Sponsors and Collaborators

  • Otsuka Pharmaceutical Development & Commercialization, Inc.

Investigators

  • Study Director: Aleksandar Skuban, M.D., Otsuka Pharmaceutical Development & Commercialization, Inc.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Otsuka Pharmaceutical Development & Commercialization, Inc.
ClinicalTrials.gov Identifier:
NCT01397786
Other Study ID Numbers:
  • 331-10-237
First Posted:
Jul 20, 2011
Last Update Posted:
May 10, 2017
Last Verified:
Apr 1, 2017
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details This trial was conducted in a total of 1072 participants (1044 of whom entered the open-label treatment phase) at 202 trial sites in the following 18 countries: Japan, Korea, Malaysia, Philippines, Taiwan, Croatia, Latvia, Poland, Romania, Russia, Serbia, Turkey, Ukraine, Columbia, Mexico, Canada, Puerto Rico, and United States of America (USA).
Pre-assignment Detail Enrollment was drawn from eligible participants who could potentially benefit from monotherapy treatment with oral brexpiprazole for schizophrenia and included rollover participants from the double-blind, phase-3 efficacy trials (ie, Trial NCT01393613, Trial NCT01396421, and Trial NCT01668797) and de novo participants from select sites.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786 . Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Period Title: Phase A
STARTED 12 0 227
COMPLETED 12 0 199
NOT COMPLETED 0 0 28
Period Title: Phase A
STARTED 611 204 229
COMPLETED 308 109 91
NOT COMPLETED 303 95 138

Baseline Characteristics

Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Total of all reporting groups
Overall Participants 611 204 257 1072
Age (participants) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [participants]
38.5
(10.8) 6.3%
39.6
(10.8) 19.4%
44.1
(11.1) 17.2%
40.0
(11.1) 3.7%
Sex: Female, Male (Count of Participants)
Female
245
40.1%
79
38.7%
85
33.1%
409
38.2%
Male
366
59.9%
125
61.3%
172
66.9%
663
61.8%

Outcome Measures

1. Primary Outcome
Title Percentage of Participants With Adverse Events (AEs)
Description A treatment-emergent adverse event (TEAE) is defined as an AE that started after start of investigational medicinal product (IMP) treatment; or if the event was continuous from baseline and was serious, IMP-related, or resulted in death, discontinuation, interruption or reduction of IMP.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
Safety sample included those participants who had at least one post-baseline efficacy evaluation for Positive and Negative Syndrome Scale (PANSS) total score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 605 202 224 1031
With AEs
60.2
9.9%
56.4
27.6%
65.2
25.4%
60.5
5.6%
With TEAEs
60.0
9.8%
56.4
27.6%
65.2
25.4%
60.4
5.6%
With SAEs
14.9
2.4%
8.9
4.4%
11.2
4.4%
12.9
1.2%
2. Secondary Outcome
Title Mean Change From Baseline in Positive and Negative Syndrome Scale Total Score
Description The PANSS consisted of 3 subscales with 30 symptom constructs (positive subscale (7): delusions, conceptual disorganization, hallucinatory behavior, excitement, grandiosity, suspiciousness/perseckion, and hostility; negative subscale (7): blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity and conversation flow, stereotyped thinking and general psychopathology subscale (16): somatic concern, anxiety, guilt feelings, tension, mannerisms and posturing, depression, motor retardation, uncooperativeness, unusual thought content, disorientation, poor attention, lack of judgment and insight, disturbance of volition, poor impulse control, preoccupation, and active social avoidance). Severity was rated on 7-point scale with scores 1 (absence) & 7 (extremely severe). The PANSS total score was sum of rating scores for 7 positive, 7 negative, and 16 general psychopathology subscale items of PANSS panel.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 223 1012
At Week 26 (Participant count=375,134,123,632)
-6.90
(12.90)
-12.50
(14.90)
-6.60
(13.60)
-8.00
(13.60)
At Week 52 (Participant count= 226,93,91,410)
-11.0
(14.40)
-18.40
(16.90)
-8.80
(12.60)
-12.20
(15.00)
At Last Visit (Participant count=591,198,223,1012)
-3.80
(16.70)
-9.70
(18.70)
-3.50
(14.30)
-4.90
(16.80)
3. Secondary Outcome
Title Mean Change From Baseline in PANSS Positive Subscale Score
Description The PANSS consisted of three subscales that contained a total of 30 symptom constructs. For each symptom construct, severity is rated on a 7-point scale, with a score of 1 indicated the absence of symptoms and a score of 7 indicated extremely severe symptoms. In positive subscale, the 7 positive symptom constructs were: delusions, conceptual disorganization, hallucinatory behavior, excitement, grandiosity, suspiciousness/persecution, and hostility.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=375,134,123,632)
-2.10
(4.50)
-4.10
(5.40)
-1.70
(4.30)
-2.40
(4.70)
At Week 52 (Participant count=226,93,91,410)
-3.20
(4.60)
-5.80
(5.20)
-2.30
(4.10)
-3.60
(4.80)
At Last Visit (Participant count=591,198,223,1012)
-0.90
(5.90)
-2.80
(6.40)
-1.00
(4.90)
-1.30
(5.80)
4. Secondary Outcome
Title Mean Change From Baseline in PANSS Negative Subscale Score
Description The PANSS consisted of three subscales that contained a total of 30 symptom constructs. For each symptom construct, severity was rated on a 7-point scale, with a score of 1 indicated the absence of symptoms and a score of 7 indicated extremely severe symptoms. In negative subscale the severity was rated for the following 7 negative symptom constructs: blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation, stereotyped thinking.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 223 1012
At Week 26 (Participant count=375,134,123,632)
-1.40
(3.70)
-2.40
(4.30)
-1.30
(3.80)
-1.60
(3.90)
At Week 52 (Participant count=226,93,91,410)
-2.70
(4.50)
-3.70
(5.40)
-2.00
(3.70)
-2.80
(4.60)
At Last Visit (Participant count=591,198,223,1012)
-1.00
(4.10)
-2.40
(5.00)
-0.60
(4.20)
-1.20
(4.30)
5. Secondary Outcome
Title Mean Change From Baseline in Clinical Global Impression - Severity of Illness Scale Score
Description The severity of illness for each participant was rated using the CGI-S. To perform this assessment, the investigator were to answer the following question: "Considering your total clinical experience with this particular population, how mentally ill was the participant at that time?" Response choices include: 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; and 7 = among the most extremely ill participants.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 223 1012
At at Week 26 (Participant count=375,134,123,632)
-0.35
(0.79)
-0.60
(0.98)
-0.24
(0.88)
-0.38
(0.86)
At Week 52 (Participant count=226,93,91,410)
-0.55
(0.86)
-0.97
(0.98)
-0.48
(0.86)
-0.63
(0.91)
At Last Visit (Participant count=591,198,223,1012)
-0.14
(1.04)
-0.46
(1.12)
-0.17
(0.88)
-0.21
(1.03)
6. Secondary Outcome
Title Mean Change From Baseline in Personal and Social Performance Scale Total Score
Description The PSP was a validated clinician-rated scale that measured personal and social functioning in four domains: socially useful activities (e.g, work and study), personal and social relationships, self-care, and disturbing and aggressive behaviors. Impairment in each of these domains was rated as absent, mild, manifest, marked, severe, or very severe. These ratings were then converted to a total score based on a 100-point scale using algorithms to identify the appropriate 10-point interval, and the rater's judgment that determined the total score within the 10-point interval. Participants with a PSP total score of 71 to 100 were considered to have mild functional difficulty. Scores of 31 to 70 represented manifest disabilities of various degrees and ratings of 1 to 30 indicated minimal functioning that required intense support and/or supervision.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=366,134,123,623)
4.50
(9.70)
6.50
(11.30)
4.50
(9.00)
4.90
(10.00)
At Week 52 (Participant count=223,93,91,407)
7.00
(10.60)
9.60
(11.90)
7.60
(10.80)
7.70
(11.00)
At Last Visit (Participant count=569,196,219,984)
1.80
(12.40)
5.10
(12.80)
2.70
(11.00)
2.70
(12.20)
7. Secondary Outcome
Title Mean Clinical Global Impression - Improvement Score
Description The efficacy of study medication was rated for each participant using the CGI-I. The investigator rated the participant's total improvement whether or not it was due to the drug treatment. All responses were compared to the participant's condition at Screening/Baseline (i.e, Week 6 visit of Protocol NCT00905307). Response choices included: 0 = not assessed, 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 598 198 123 1012
At Week 26 (Participant count=381,134,123,638)
3.00
(1.13)
2.77
(0.99)
3.00
(1.13)
2.95
(1.10)
At Week 52 (Participant count=226,93,91,410)
2.66
(1.13)
2.26
(0.97)
2.76
(1.09)
2.59
(1.10)
At Last Visit (Participant count=598,198,223,1019)
3.31
(1.43)
2.96
(1.33)
3.30
(1.27)
3.24
(1.38)
8. Secondary Outcome
Title Response Rate
Description Response rate was defined as a reduction of ≥ 30% from Baseline in PANSS total score or CGI-I score of 1 (very much improved) or 2 (much improved) at the Last Visit.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 605 202 224 1031
Number [percentage of participants]
34.2
5.6%
42.6
20.9%
27.2
10.6%
34.3
3.2%
9. Secondary Outcome
Title Discontinuation Rate for Lack of Efficacy
Description Discontinuation rate for the participants who discontinued due to lack of efficacy were examined.
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 605 202 224 1031
Number [percentage of participants]
3.6
0.6%
3.5
1.7%
6.3
2.5%
4.2
0.4%
10. Secondary Outcome
Title Mean Change From Baseline in Positive and Negative Syndrome Scale Excited Component Score
Description The PEC score consisted of five PANSS items: excitement (P4), hostility (P7), tension (G4), uncooperativeness (G8), and poor impulse control (G14). Each of the items were rated on a scale of 1 (absent) to 7 (extreme). The PEC scores ranged from 5 (not present) to 35 (extremely severe).
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=375,134,123,632)
-0.60
(3.10)
-1.80
(3.70)
-0.70
(3.10)
-0.90
(3.30)
At Week 52 (Participant count=226,93,91,410)
-1.20
(3.20)
-2.60
(3.40)
-1.00
(2.90)
-1.50
(3.20)
At Last Visit (Participant count=591,198,223,1012)
0.10
(4.10)
-0.90
(4.20)
-0.30
(3.50)
-0.20
(4.00)
11. Secondary Outcome
Title Mean Change From Baseline in PANSS Marder Factor Scores - Positive Symptoms Score
Description Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The positive factor score was the sum of the 8 components (delusions (P1), hallucinatory behavior (P3), grandiosity (P5), suspiciousness/persecution (P6), stereotyped thinking (N7), somatic concern (G1), unusual thought content (G9) and lack of judgment and insight (G12)) of the positive symptoms scale (range: 8 - best possible outcome to 56 - worst possible outcome).
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=375,134,123,632)
-2.60
(4.80)
-4.70
(5.50)
-2.00
(5.20)
-2.90
(5.10)
At Week 52 (Participant count=226,93,91,410)
-3.90
(5.20)
-6.60
(5.70)
-2.60
(4.80)
-4.20
(5.40)
At Last Visit (Participant count=591,198,223,1012)
-1.60
(5.90)
-3.50
(6.50)
-1.30
(5.00)
-1.90
(5.90)
12. Secondary Outcome
Title Mean Change From Baseline in PANSS Marder Factor Scores - Negative Symptoms Score
Description Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The negative factor score is the sum of the 7 items (blunted affect (N1), emotional withdrawal (N2), poor rapport (N3), passive/apathetic social withdrawal (N4), lack of spontaneity and conversation flow (N6), motor retardation (G7) and active social avoidance (G16)) of the negative subscale (range: 8 - best possible outcome to 56 - worst possible outcome).
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=375,134,123,632)
-1.50
(3.60)
-2.20
(4.00)
-1.70
(4.10)
-1.70
(3.80)
At Week 52 (Participant count=226,93,91,410)
-2.60
(4.30)
-3.90
(5.00)
-2.20
(3.80)
-2.80
(4.40)
At Last Visit (Participant count=591,198,223,1012)
-1.00
(4.10)
-2.30
(5.10)
-0.70
(4.10)
-1.20
(4.40)
13. Secondary Outcome
Title Mean Change From Baseline in PANSS Marder Factor Scores - Disorganized Thought Score
Description Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The disorganized thoughts factor score is the sum of score from the 7 items (conceptual disorganization (P2), difficulty in abstract thinking (N5), mannerisms and posturing (G5), disorientation (G10), poor attention (G11), disturbance of volition (G13) and preoccupation (G15)) on the disorganized thoughts subscale (range: 7 - best possible outcome to 49 - worst possible outcome).
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=375,134,123,632)
-1.70
(3.30)
-2.60
(3.50)
-1.70
(3.50)
-1.90
(3.40)
At Week 52 (Participant count=226,93,91,410)
-2.90
(3.70)
-3.70
(4.60)
-2.30
(3.70)
-2.90
(4.00)
At Last Visit (Participant count=591,198,223,1012)
-1.20
(4.20)
-2.20
(4.50)
-0.90
(4.00)
-1.40
(4.20)
14. Secondary Outcome
Title Mean Change From Baseline in PANSS Marder Factor Scores - Hostility/ Excitement Score
Description Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The uncontrolled hostility/excitement factor score is the sum of score from the 4 items (excitement (P4), hostility (P7), uncooperativeness (G8) and poor impulse control (G14)) on the uncontrolled hostility/excitement subscale (range: 4 - best possible outcome to 28 - worst possible outcome).
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=375,134,123,632)
-0.40
(2.70)
-1.40
(3.10)
-0.60
(2.60)
-0.60
(2.80)
At Week 52 (Participant count=226,93,91,410)
-0.80
(2.70)
-1.90
(2.90)
-0.90
(2.30)
-1.10
(2.70)
At Last Visit (Participant count=591,198,223,1012)
0.20
(3.40)
-0.70
(3.50)
-0.30
(3.00)
-0.10
(3.40)
15. Secondary Outcome
Title Mean Change From Baseline in PANSS Marder Factor Scores - Anxiety/Depression Score
Description Retrospective factor analyses have been performed in recent decades using scores for the 30 individual PANSS items to categorize symptoms into 5 dimensions. Collectively, these dimensions are referred to as the PANSS Marder Factor scores and include positive symptoms score, negative symptoms score, thought score, uncontrolled hostility/excitement, anxiety depression score. The anxiety/depression factor score is the sum of score from the 4 items (anxiety (G2), guilt feelings (G3), tension (G4) and depression (G6)) on the anxiety/depression subscale (range: 4 - best possible outcome to 28 - worst possible outcome).
Time Frame From Baseline up to 52 Weeks

Outcome Measure Data

Analysis Population Description
The Efficacy Sample included participants in the Safety Sample who had at least 1 post-baseline efficacy evaluation for PANSS Total Score.
Arm/Group Title Prior Brexpiprazole Prior Placebo De Novo Total
Arm/Group Description Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who rolled over from, and received blinded brexpiprazole/placebo in, one of the randomized, double blind, placebo controlled Phase 3 efficacy studies (Vector, NCT01396421;Beacon, NCT01393613; and Equator, NCT01668797); or de novo patients, All received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786.
Measure Participants 591 198 123 1012
At Week 26 (Participant count=375,134,123,632)
-0.70
(2.60)
-1.50
(3.00)
-0.70
(3.40)
-0.90
(2.90)
At Week 52 (Participant count=226,93,91,410)
-0.90
(2.50)
-2.40
(2.90)
-0.80
(3.50)
-1.20
(2.90)
At Last Visit (Participant count=591,198,223,1012)
-0.20
(3.20)
-0.90
(3.40)
-0.40
(3.80)
-0.40
(3.40)

Adverse Events

Time Frame The trial required that participants be actively monitored for AEs up to 30 (+2) days after the last dose of study drug, up to 52 weeks.
Adverse Event Reporting Description An adverse event (AE) was defined as any untoward medical occurrence associated with use of a drug in humans, whether or not considered drug related. Serious adverse event (SAE) includes any AE that meets the either one or more seriousness criteria mentioned in the study protocol. An immediately Reportable Event (IRE) was defined as any SAE, AE/pregnancy cases that necessitates discontinuation of IMP/potential Hy's Law cases. Included participants who received at least 1 dose of open-label IMP.
Arm/Group Title De Novo (Phase A) Prior Brexpiprazole (Phase B) Prior Placebo (Phase B) De Novo (Phase B)
Arm/Group Description Participants underwent cross-titration to oral brexpiprazole for 4 weeks in Phase A. DeNovo participants in Phase A received brexpiprazole monotherapy starting dose of 2 mg daily at the conversion Week 4 visit (baseline visit of Phase B). Participants who received at least 1 dose of study drug were included in this phase. NOTE: 12 participants from the trial P33110232 were excluded in this analysis. Participants who rolled over from, and received blinded brexpiprazole in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who received at least 1 dose of study drug were included in this phase. NOTE: Six participants from the trial P33110231 were excluded in this analysis. Participants who rolled over from, and received blinded placebo in, one of the randomized, double-blind, placebo-controlled Phase 3 efficacy studies (Vector, NCT01396421; Beacon, NCT01393613; and Equator, NCT01668797); all received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who received at least 1 dose of study drug were included in this phase. NOTE: One participant each from the trials P33110230 and P33110231 were excluded in this analysis. Participants who had not previously participated in a brexpiprazole clinical study and who received 1-4 mg of daily treatment with open label brexpiprazole in trial NCT01397786. Participants who received at least 1 dose of study drug were included in this phase. NOTE: Five participants from Phase B - Denovo were excluded in this analysis.
All Cause Mortality
De Novo (Phase A) Prior Brexpiprazole (Phase B) Prior Placebo (Phase B) De Novo (Phase B)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN) / (NaN) / (NaN)
Serious Adverse Events
De Novo (Phase A) Prior Brexpiprazole (Phase B) Prior Placebo (Phase B) De Novo (Phase B)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 4/226 (1.8%) 90/605 (14.9%) 18/202 (8.9%) 25/224 (11.2%)
Cardiac disorders
Cardiac failure 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Cardiac failure congestive 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Coronary artery disease 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Gastrointestinal disorders
Abdominal hernia 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Duodenal ulcer perforation 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Gastric ulcer perforation 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
General disorders
Asthenia 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 1/224 (0.4%)
Infections and infestations
Appendicitis 0/226 (0%) 2/605 (0.3%) 0/202 (0%) 0/224 (0%)
Peritonitis 0/226 (0%) 2/605 (0.3%) 0/202 (0%) 0/224 (0%)
Pneumonia 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Sepsis 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Septic shock 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Injury, poisoning and procedural complications
Rib fracture 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Toxicity to various agents 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Metabolism and nutrition disorders
Diabetic ketoacidosis 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Endometrial cancer 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Uterine cancer 0/226 (0%) 0/605 (0%) 1/202 (0.5%) 0/224 (0%)
Nervous system disorders
Akathisia 0/226 (0%) 2/605 (0.3%) 0/202 (0%) 0/224 (0%)
Cerebrovascular accident 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Seizure 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Somnolence 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Psychiatric disorders
Schizophrenia 2/226 (0.9%) 68/605 (11.2%) 12/202 (5.9%) 10/224 (4.5%)
Psychotic disorder 1/226 (0.4%) 7/605 (1.2%) 3/202 (1.5%) 4/224 (1.8%)
Agitation 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 1/224 (0.4%)
Anxiety 0/226 (0%) 0/605 (0%) 0/202 (0%) 2/224 (0.9%)
Schizophrenia, Paranoid type 0/226 (0%) 1/605 (0.2%) 1/202 (0.5%) 0/224 (0%)
Acute psychosis 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Completed suicide 0/226 (0%) 0/605 (0%) 1/202 (0.5%) 0/224 (0%)
Emotional disorder 0/226 (0%) 0/605 (0%) 1/202 (0.5%) 0/224 (0%)
Hallucination, auditory 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Suicidal ideation 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Suicide attempt 0/226 (0%) 1/605 (0.2%) 0/202 (0%) 0/224 (0%)
Suicidal behaviour 1/226 (0.4%) 0/605 (0%) 0/202 (0%) 0/224 (0%)
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease 0/226 (0%) 0/605 (0%) 0/202 (0%) 1/224 (0.4%)
Other (Not Including Serious) Adverse Events
De Novo (Phase A) Prior Brexpiprazole (Phase B) Prior Placebo (Phase B) De Novo (Phase B)
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/226 (0%) 166/605 (27.4%) 53/202 (26.2%) 95/256 (37.1%)
Investigations
Weight increased 0/226 (0%) 47/605 (7.8%) 15/202 (7.4%) 23/256 (9%)
Nervous system disorders
Akathisia 0/226 (0%) 22/605 (3.6%) 14/202 (6.9%) 14/256 (5.5%)
Headache 0/226 (0%) 42/605 (6.9%) 14/202 (6.9%) 24/256 (9.4%)
Psychiatric disorders
Agitation 0/226 (0%) 30/605 (5%) 7/202 (3.5%) 23/256 (9%)
Insomnia 0/226 (0%) 51/605 (8.4%) 17/202 (8.4%) 32/256 (12.5%)
Vascular disorders
Hypertension 0/226 (0%) 10/605 (1.7%) 2/202 (1%) 20/256 (7.8%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

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

The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days from the time submitted to the sponsor for review. The sponsor cannot require changes to the communication and cannot extend the embargo.

Results Point of Contact

Name/Title Global Medical Affairs
Organization Otsuka Pharmaceutical Development and Commercialization, Inc.
Phone 800 562-3974
Email
Responsible Party:
Otsuka Pharmaceutical Development & Commercialization, Inc.
ClinicalTrials.gov Identifier:
NCT01397786
Other Study ID Numbers:
  • 331-10-237
First Posted:
Jul 20, 2011
Last Update Posted:
May 10, 2017
Last Verified:
Apr 1, 2017