A Study in Schizophrenic Patients

Sponsor
Denovo Biopharma LLC (Industry)
Overall Status
Terminated
CT.gov ID
NCT01125358
Collaborator
(none)
82
22
4
28.1
3.7
0.1

Study Details

Study Description

Brief Summary

This study is designed to compare 3 doses of LY2140023 for the treatment of schizophrenia as assessed at endpoint (up to 7 weeks) using the Clinical Utility Index (CUI), a measure of efficacy, safety, and tolerability.

Condition or Disease Intervention/Treatment Phase
Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
82 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
A Multicenter, Double-Blind, Placebo-Controlled Study of 3 Doses of LY2140023 in Patients With DSM-IV-TR Schizophrenia
Study Start Date :
May 1, 2010
Actual Primary Completion Date :
Sep 1, 2012
Actual Study Completion Date :
Sep 1, 2012

Arms and Interventions

Arm Intervention/Treatment
Experimental: 10 milligrams (mg) LY2140023

Drug: LY2140023
Administered orally, twice daily for up to 7 weeks of treatment

Experimental: 80 mg LY2140023

Drug: LY2140023
Administered orally, twice daily for up to 7 weeks of treatment

Experimental: 160 mg LY2140023

Drug: LY2140023
Administered orally, twice daily for up to 7 weeks of treatment

Placebo Comparator: Placebo

Drug: Placebo
Administered orally, twice daily for up to 7 weeks of treatment

Outcome Measures

Primary Outcome Measures

  1. Clinical Utility Index (CUI) [Baseline through Week 6]

    CUI measures the efficacy (response), tolerability (time on treatment) and safety [incidence of adverse events (AEs)] by quantifying these 3 attributes and provides a single metric for overall treatment outcome. Each component is given a score ranging from 0 to 5. The CUI Total Score is the sum of the 3 items and ranges from 0 to 15. The greater the CUI Total Score, the more effective the treatment. If a participant experiences a drug-related seizure/death, the safety component is given a score of 0 resulting in an overall CUI Total Score of 0. Analysis of variance (ANOVA) was used to calculate Least Squares (LS) mean and standard error. LS mean values were controlled for treatment, gender and pooled investigators.

Secondary Outcome Measures

  1. Change From Baseline to Week 6 Endpoint in the Positive and Negative Syndrome Scale (PANSS) Total Score, Positive Score, Negative Score, and Psychopathology Subscale [Baseline, Week 6]

    The PANSS consists of 30 items and 3 subscales designed to measure severity of psychopathology in schizophrenia. The PANSS Positive Subscale and the PANSS Negative Subscale each contain 7 items, and the remaining 16 items make up the PANSS General Psychopathology Subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). The PANSS Total Score is the sum of the 30 items (range from 30 to 210). The PANSS Positive Subscale and PANSS Negative Subscale scores each range from 7 to 49. The PANSS General Psychopathology Subscale score ranges from 16 to 112. Higher scores indicate greater severity of illness. The Mixed Model Repeated Measures (MMRM) analysis was used to calculate Least Squares (LS) mean and 95% confidence interval. LS mean values were controlled for baseline, treatment, gender, pooled investigator, visit, treatment*visit and baseline*visit.

  2. Change From Baseline to Week 6 Endpoint in the Clinical Global Impression-Severity Scale (CGI-S) [Baseline, Week 6]

    The CGI-S instrument is used to record the severity of mental illness at the time of assessment. The score ranges from 1 (normal, not at all ill) to 7 (among the most extremely ill). Higher scores indicate greater severity of illness. The Mixed Model Repeated Measures (MMRM) analysis was used to calculate Least Squares (LS) mean and 95% confidence interval. LS mean values were controlled for baseline, treatment, gender, pooled investigator, visit, treatment*visit and baseline*visit.

  3. Change From Baseline to Week 6 Endpoint in the 16-item Negative Symptoms Assessment (NSA-16) [Baseline, Week 6]

    The NSA-16 scale is used to help clinicians rate behaviors (not psychopathology) commonly associated with negative symptoms of schizophrenia. The scale rates participants on 16 "anchors". Each item ("anchor") is rated from 1 (better) to 6 (worse). The NSA-16 Total Score is the sum of the 16 specific items and ranges from 16 to 96. Higher scores indicate greater severity of illness. The Mixed Model Repeated Measures (MMRM) analysis was used to calculate Least Squares (LS) mean and 95% confidence interval. LS mean values were controlled for baseline, treatment, gender, pooled investigator, visit, treatment*visit and baseline*visit.

  4. The Number of Participants With Treatment-Emergent Suicidal Ideation and Behavior Based on the Columbia Suicide Severity Rating Scale (C-SSRS) [Baseline up to Week 6]

    Columbia Suicide Rating Scale (C-SSRS) captures occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal ideation: a "yes" answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation. Suicidal behavior: a "yes" answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, non-fatal suicide attempt, and completed suicide. The number of participants with statistically significant changes of the C-SSRS was the number of participants with a treatment-emergent suicidal ideation and behavior (an increase in suicidal behavior or ideation over lead-in baseline.)

  5. Percentage of Participants Who Discontinued (Rate of Discontinuation) [Baseline through Week 6]

    Rate of discontinuation was calculated as the number of participants who discontinued from study due to any reason divided by the total number of participants who received study drug, then multiplied by 100.

Eligibility Criteria

Criteria

Ages Eligible for Study:
20 Years to 65 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Diagnosis of schizophrenia as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; APA 2000) (Disorganized, 295.10; Catatonic, 295.20; Paranoid 295.30; or Undifferentiated, 295.90) and confirmed by the Structured Clinical Interview for DSM-IV-TR (SCID)

  • Non pregnant female participants who agree to use acceptable birth control

  • At entry to the study must be considered moderately ill in the opinion of the investigator

  • 1 year history of Schizophrenia prior to entering the study

  • At study entry participants with a history of antipsychotic treatment must have a lifetime history of at least one hospitalization for the treatment of schizophrenia, not including the hospitalization required for study based on the investigator's clinical judgment. Participants who have never taken antipsychotic treatment may enter the study even without a history of hospitalization

  • At study entry participants with a history of antipsychotic treatment must have a history of at least one episode of illness exacerbation requiring an intensification of treatment intervention or care in the last 2 years, not including the present episode of illness. Participants who have never taken antipsychotic treatment may enter the study without a past history of illness exacerbation and intensification of treatment in the last 2 years

  • At study entry participants must have experienced an exacerbation of illness within the 4 weeks prior to entering the study, leading to an intensification of psychiatric care in the opinion of the investigator. If exacerbation occurs in participants who are presently hospitalized, the participants must not have been hospitalized longer than 60 days at entry of the study

Exclusion Criteria:
  • Participated in any clinical trial with any pharmacological treatment intervention for which they received a study-related medication in the 6 months prior to visit 1

  • Previously completed or withdrawn from this study, or any other study investigating LY2140023 or any predecessor molecules with glutamatergic activity

  • Have any known history of receiving treatment with clozapine at any dose, as determined at baseline

  • Have received treatment with a depot formulation of an antipsychotic medication within the 6 months prior entering the study

  • Participants who are currently suicidal

  • Females who are pregnant, nursing, or who intend to become pregnant within 30 days of completing the study

  • Participants with uncorrected narrow-angle glaucoma, uncontrolled diabetes, certain diseases of the liver, renal insufficiency, untreated thyroid condition or other serious or unstable illnesses

  • Have a history of one or more seizures, except for those who experienced a single simple febrile seizure between ages 6 months and 5 years

  • Participants are excluded if their biological father, mother, brother, sister, or child has a history of idiopathic epilepsy

  • Within 1 year of study enrollment, participants have a history of central nervous system infection, uncontrolled migraine, transient ischemic attack (TIA), or head trauma with loss of consciousness or a post-concussive

  • Participants are excluded if they have a lifetime history of any of the following:

  • head trauma, stroke, or central nervous system (CNS) infection with persistent neurological deficit (focal or diffuse);

  • brain surgery;

  • an electroencephalogram with paroxysmal (epileptiform) activity, or

  • brain structural lesion, including developmental abnormalities, as determined by examination or previous neuroimaging studies that are consistent with a diagnosable neurological disease or syndrome

  • Electroconvulsive therapy (ECT) within 3 months of entering the study or who will have ECT at any time during the study

  • Leukopenia

  • Medical history of Human Immunodeficiency Virus positive (HIV+) status

  • Higher than normal blood prolactin levels

  • Certain electrocardiogram results

Contacts and Locations

Locations

Site City State Country Postal Code
1 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Aichi Japan 470-1168
2 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Kanagawa Japan 216-0003
3 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Kumamoto Japan 861-0002
4 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Kyoto Japan 625-8502
5 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Nagano Japan 384-8540
6 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Nagasaki Japan 856-0847
7 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Nara Japan 634-8522
8 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Osaka Japan 569-1041
9 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Saga Japan 842-0192
10 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Tokyo Japan 114-0024
11 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Toyama Japan 939-8073
12 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Yamaguchi Japan 759-6321
13 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Goyang-Si Korea, Republic of 410-719
14 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Incheon Korea, Republic of 400-711
15 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Naju Korea, Republic of 520-833
16 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Seoul Korea, Republic of 150-713
17 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Suwon-City Korea, Republic of 442-723
18 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Yongin Korea, Republic of 446-769
19 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Changhua Taiwan 50550
20 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Hsinchu Taiwan 802
21 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Taipei Taiwan 110
22 For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. Taipei Taiwan 114

Sponsors and Collaborators

  • Denovo Biopharma LLC

Investigators

  • Study Director: Call 1-877-CTLILLY(1-877-285-4559) or 1-317-615-4459 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST), Eli Lilly and Company

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Denovo Biopharma LLC
ClinicalTrials.gov Identifier:
NCT01125358
Other Study ID Numbers:
  • 13560
  • H8Y-JE-HBDC
First Posted:
May 18, 2010
Last Update Posted:
Sep 14, 2021
Last Verified:
Nov 1, 2012
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail This study consisted of a 1-week placebo lead-in period and a 6-week randomized, double-blind treatment period. Placebo responder is defined as ≥25% improvement in Positive and Negative Syndrome Scale (PANSS) Total Score from the start of placebo lead-in period to the end of placebo lead-in period.
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks.
Period Title: Overall Study
STARTED 21 21 20 20
Received at Least 1 Dose of Study Drug 21 21 20 20
Placebo Responder 1 0 0 0
COMPLETED 9 17 11 12
NOT COMPLETED 12 4 9 8

Baseline Characteristics

Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo Total
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks. Total of all reporting groups
Overall Participants 21 21 20 20 82
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
40.99
(10.98)
42.03
(10.41)
43.16
(10.33)
38.34
(9.91)
41.14
(10.38)
Sex: Female, Male (Count of Participants)
Female
11
52.4%
10
47.6%
9
45%
10
50%
40
48.8%
Male
10
47.6%
11
52.4%
11
55%
10
50%
42
51.2%
Race/Ethnicity, Customized (participants) [Number]
Asian
21
100%
21
100%
20
100%
20
100%
82
100%
Region of Enrollment (participants) [Number]
Taiwan
1
4.8%
2
9.5%
1
5%
1
5%
5
6.1%
Japan
18
85.7%
16
76.2%
17
85%
17
85%
68
82.9%
Korea, Republic of
2
9.5%
3
14.3%
2
10%
2
10%
9
11%

Outcome Measures

1. Primary Outcome
Title Clinical Utility Index (CUI)
Description CUI measures the efficacy (response), tolerability (time on treatment) and safety [incidence of adverse events (AEs)] by quantifying these 3 attributes and provides a single metric for overall treatment outcome. Each component is given a score ranging from 0 to 5. The CUI Total Score is the sum of the 3 items and ranges from 0 to 15. The greater the CUI Total Score, the more effective the treatment. If a participant experiences a drug-related seizure/death, the safety component is given a score of 0 resulting in an overall CUI Total Score of 0. Analysis of variance (ANOVA) was used to calculate Least Squares (LS) mean and standard error. LS mean values were controlled for treatment, gender and pooled investigators.
Time Frame Baseline through Week 6

Outcome Measure Data

Analysis Population Description
All participants who received at least 1 dose of study drug and had CUI Total Score measurement at Week 6.
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks.
Measure Participants 21 21 20
Least Squares Mean (Standard Error) [units on a scale]
8.30
(0.54)
10.32
(0.52)
9.27
(0.55)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, 80 mg LY2140023
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -2.02
Confidence Interval (2-Sided) 90%
-3.37 to 0.00
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, 160 mg LY2140023
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -1.05
Confidence Interval (2-Sided) 90%
-2.42 to 0.32
Parameter Dispersion Type:
Value:
Estimation Comments
2. Secondary Outcome
Title Change From Baseline to Week 6 Endpoint in the Positive and Negative Syndrome Scale (PANSS) Total Score, Positive Score, Negative Score, and Psychopathology Subscale
Description The PANSS consists of 30 items and 3 subscales designed to measure severity of psychopathology in schizophrenia. The PANSS Positive Subscale and the PANSS Negative Subscale each contain 7 items, and the remaining 16 items make up the PANSS General Psychopathology Subscale. Each item is rated from 1 (symptom not present) to 7 (symptom extremely severe). The PANSS Total Score is the sum of the 30 items (range from 30 to 210). The PANSS Positive Subscale and PANSS Negative Subscale scores each range from 7 to 49. The PANSS General Psychopathology Subscale score ranges from 16 to 112. Higher scores indicate greater severity of illness. The Mixed Model Repeated Measures (MMRM) analysis was used to calculate Least Squares (LS) mean and 95% confidence interval. LS mean values were controlled for baseline, treatment, gender, pooled investigator, visit, treatment*visit and baseline*visit.
Time Frame Baseline, Week 6

Outcome Measure Data

Analysis Population Description
All randomized participants who received at least 1 dose of study drug, had a baseline and at least 1 post-baseline PANSS measurement. Placebo responder (defined as ≥25% improvement in the PANSS Total Score from the start of placebo lead-in period to the end of placebo lead-in period) was excluded from the analysis.
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks.
Measure Participants 19 21 20 20
PANSS Total Score
-0.49
-2.56
1.40
9.35
PANSS Positive Subscore (n=19, 21, 20, 20)
0.33
-2.30
-0.05
1.93
PANSS Negative Subscore
0.23
-0.22
0.33
2.70
PANSS General Psychopathology Subscore
-0.88
-0.31
1.18
4.79
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.222
Comments P-value is for PANSS Total Score.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -9.84
Confidence Interval (2-Sided) 95%
-25.80 to 6.12
Parameter Dispersion Type: Standard Error of the Mean
Value: 7.96
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.105
Comments P-value is for PANSS Total Score.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -11.91
Confidence Interval (2-Sided) 95%
-26.42 to 2.60
Parameter Dispersion Type: Standard Error of the Mean
Value: 7.22
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection 160 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.308
Comments P-value is for PANSS Total Score.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -7.96
Confidence Interval (2-Sided) 95%
-23.46 to 7.55
Parameter Dispersion Type: Standard Error of the Mean
Value: 7.73
Estimation Comments
Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.441
Comments P-value is for PANSS Positive Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -1.60
Confidence Interval (2-Sided) 95%
-5.74 to 2.54
Parameter Dispersion Type: Standard Error of the Mean
Value: 2.06
Estimation Comments
Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.030
Comments P-value is for PANSS Positive Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -4.22
Confidence Interval () 95%
-8.01 to -0.44
Parameter Dispersion Type: Standard Error of the Mean
Value: 1.88
Estimation Comments
Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection 160 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.323
Comments P-value is for PANSS Positive Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -1.98
Confidence Interval (2-Sided) 95%
-5.96 to 2.01
Parameter Dispersion Type: Standard Error of the Mean
Value: 1.98
Estimation Comments
Statistical Analysis 7
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.285
Comments P-value is for PANSS Negative Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -2.46
Confidence Interval (2-Sided) 95%
-7.05 to 2.12
Parameter Dispersion Type: Standard Error of the Mean
Value: 2.28
Estimation Comments
Statistical Analysis 8
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.166
Comments P-value is for PANSS Negative Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -2.92
Confidence Interval (2-Sided) 95%
-7.10 to 1.26
Parameter Dispersion Type: Standard Error of the Mean
Value: 2.07
Estimation Comments
Statistical Analysis 9
Statistical Analysis Overview Comparison Group Selection 160 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.286
Comments P-value is for PANSS Negative Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -2.37
Confidence Interval (2-Sided) 95%
-6.79 to 2.05
Parameter Dispersion Type: Standard Error of the Mean
Value: 2.20
Estimation Comments
Statistical Analysis 10
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.177
Comments P-value is for PANSS General Psychopathology Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -5.67
Confidence Interval (2-Sided) 95%
-13.96 to 2.63
Parameter Dispersion Type: Standard Error of the Mean
Value: 4.14
Estimation Comments
Statistical Analysis 11
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.178
Comments P-value is for PANSS General Psychopathology Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -5.10
Confidence Interval (2-Sided) 95%
-12.60 to 2.40
Parameter Dispersion Type: Standard Error of the Mean
Value: 3.74
Estimation Comments
Statistical Analysis 12
Statistical Analysis Overview Comparison Group Selection 160 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.377
Comments P-value is for PANSS General Psychopathology Subscore.
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -3.61
Confidence Interval (2-Sided) 95%
-11.72 to 4.51
Parameter Dispersion Type: Standard Error of the Mean
Value: 4.05
Estimation Comments
3. Secondary Outcome
Title Change From Baseline to Week 6 Endpoint in the Clinical Global Impression-Severity Scale (CGI-S)
Description The CGI-S instrument is used to record the severity of mental illness at the time of assessment. The score ranges from 1 (normal, not at all ill) to 7 (among the most extremely ill). Higher scores indicate greater severity of illness. The Mixed Model Repeated Measures (MMRM) analysis was used to calculate Least Squares (LS) mean and 95% confidence interval. LS mean values were controlled for baseline, treatment, gender, pooled investigator, visit, treatment*visit and baseline*visit.
Time Frame Baseline, Week 6

Outcome Measure Data

Analysis Population Description
All randomized participants who received at least 1 dose of study drug, had a baseline and at least 1 post-baseline CGI-S measurement. Placebo responder (defined as ≥25% improvement in the PANSS Total Score from the start of placebo lead-in period to the end of placebo lead-in period) was excluded from the analysis.
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks.
Measure Participants 19 21 20 20
Least Squares Mean (95% Confidence Interval) [units on a scale]
0.62
-0.49
0.14
-0.25
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.077
Comments
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value 0.87
Confidence Interval (2-Sided) 95%
-0.10 to 1.83
Parameter Dispersion Type: Standard Error of the Mean
Value: 0.48
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.592
Comments
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -0.24
Confidence Interval (2-Sided) 95%
-1.12 to 0.65
Parameter Dispersion Type: Standard Error of the Mean
Value: 0.44
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection 160 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.395
Comments
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value 0.39
Confidence Interval (2-Sided) 95%
-0.53 to 1.32
Parameter Dispersion Type: Standard Error of the Mean
Value: 0.46
Estimation Comments
4. Secondary Outcome
Title Change From Baseline to Week 6 Endpoint in the 16-item Negative Symptoms Assessment (NSA-16)
Description The NSA-16 scale is used to help clinicians rate behaviors (not psychopathology) commonly associated with negative symptoms of schizophrenia. The scale rates participants on 16 "anchors". Each item ("anchor") is rated from 1 (better) to 6 (worse). The NSA-16 Total Score is the sum of the 16 specific items and ranges from 16 to 96. Higher scores indicate greater severity of illness. The Mixed Model Repeated Measures (MMRM) analysis was used to calculate Least Squares (LS) mean and 95% confidence interval. LS mean values were controlled for baseline, treatment, gender, pooled investigator, visit, treatment*visit and baseline*visit.
Time Frame Baseline, Week 6

Outcome Measure Data

Analysis Population Description
All randomized participants who received at least 1 dose of study drug, had a baseline and at least 1 post-baseline NSA-16 Total Score measurement. Placebo responder (defined as ≥25% improvement in the PANSS Total Score from the start of placebo lead-in period to the end of placebo lead-in period) was excluded from the analysis.
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks.
Measure Participants 13 17 14 13
Least Squares Mean (95% Confidence Interval) [units on a scale]
3.42
-0.40
-6.31
-1.22
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.306
Comments
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value 4.64
Confidence Interval (2-Sided) 95%
-4.37 to 13.65
Parameter Dispersion Type: Standard Error of the Mean
Value: 4.49
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.849
Comments
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value 0.82
Confidence Interval (2-Sided) 95%
-7.74 to 9.38
Parameter Dispersion Type: Standard Error of the Mean
Value: 4.26
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection 160 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.259
Comments
Method MMRM
Comments
Method of Estimation Estimation Parameter LS Mean Differences
Estimated Value -5.09
Confidence Interval () 95%
-14.05 to 3.86
Parameter Dispersion Type: Standard Error of the Mean
Value: 4.46
Estimation Comments
5. Secondary Outcome
Title The Number of Participants With Treatment-Emergent Suicidal Ideation and Behavior Based on the Columbia Suicide Severity Rating Scale (C-SSRS)
Description Columbia Suicide Rating Scale (C-SSRS) captures occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal ideation: a "yes" answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation. Suicidal behavior: a "yes" answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, non-fatal suicide attempt, and completed suicide. The number of participants with statistically significant changes of the C-SSRS was the number of participants with a treatment-emergent suicidal ideation and behavior (an increase in suicidal behavior or ideation over lead-in baseline.)
Time Frame Baseline up to Week 6

Outcome Measure Data

Analysis Population Description
All randomized participants who received at least 1 dose of study drug and had a baseline and at least 1 post-baseline C-SSRS measurements.
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks.
Measure Participants 20 21 20 20
Treatment-Emergent Suicidal Ideation
1
4.8%
1
4.8%
2
10%
1
5%
Treatment-Emergent Suicidal Behavior
0
0%
0
0%
0
0%
0
0%
6. Secondary Outcome
Title Percentage of Participants Who Discontinued (Rate of Discontinuation)
Description Rate of discontinuation was calculated as the number of participants who discontinued from study due to any reason divided by the total number of participants who received study drug, then multiplied by 100.
Time Frame Baseline through Week 6

Outcome Measure Data

Analysis Population Description
All randomized participants who received at least 1 dose of study drug.
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks.
Measure Participants 21 21 20 20
Number [percentage of participants]
57.1
271.9%
19.0
90.5%
45.0
225%
40.0
200%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 10 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.354
Comments
Method Fisher Exact
Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection 80 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.181
Comments
Method Fisher Exact
Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection 160 mg LY2140023, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value >0.999
Comments
Method Fisher Exact
Comments

Adverse Events

Time Frame
Adverse Event Reporting Description
Arm/Group Title 10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Arm/Group Description 5 milligrams (mg) of LY2140023 orally, twice daily for 6 weeks. 40 mg of LY2140023 orally, twice daily for 6 weeks. 80 mg of LY2140023 orally, twice daily for 6 weeks. Placebo orally, twice daily for 6 weeks.
All Cause Mortality
10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN) / (NaN) / (NaN)
Serious Adverse Events
10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 1/21 (4.8%) 2/21 (9.5%) 0/20 (0%) 2/20 (10%)
Nervous system disorders
Psychomotor hyperactivity 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Psychiatric disorders
Schizophrenia 0/21 (0%) 0 2/21 (9.5%) 2 0/20 (0%) 0 2/20 (10%) 2
Other (Not Including Serious) Adverse Events
10 mg LY2140023 80 mg LY2140023 160 mg LY2140023 Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 13/21 (61.9%) 13/21 (61.9%) 12/20 (60%) 9/20 (45%)
Eye disorders
Visual impairment 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Gastrointestinal disorders
Abdominal pain 0/21 (0%) 0 0/21 (0%) 0 0/20 (0%) 0 1/20 (5%) 1
Cheilitis 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 1/20 (5%) 1
Constipation 1/21 (4.8%) 2 1/21 (4.8%) 1 0/20 (0%) 0 1/20 (5%) 1
Dry mouth 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Nausea 2/21 (9.5%) 2 3/21 (14.3%) 3 2/20 (10%) 3 1/20 (5%) 1
Oral disorder 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Retching 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Stomatitis 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Vomiting 1/21 (4.8%) 1 4/21 (19%) 4 1/20 (5%) 1 2/20 (10%) 2
General disorders
Malaise 0/21 (0%) 0 0/21 (0%) 0 0/20 (0%) 0 1/20 (5%) 1
Infections and infestations
Nasopharyngitis 1/21 (4.8%) 1 0/21 (0%) 0 3/20 (15%) 3 1/20 (5%) 1
Oral herpes 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Tinea pedis 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Injury, poisoning and procedural complications
Accidental overdose 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 1/20 (5%) 1
Contusion 1/21 (4.8%) 1 1/21 (4.8%) 2 0/20 (0%) 0 0/20 (0%) 0
Excoriation 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 0/20 (0%) 0
Joint injury 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Laceration 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Upper limb fracture 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Investigations
Alanine aminotransferase increased 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Aspartate aminotransferase increased 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Blood bilirubin increased 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Blood bilirubin unconjugated increased 0/21 (0%) 0 0/21 (0%) 0 0/20 (0%) 0 1/20 (5%) 1
Blood glucose increased 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 0/20 (0%) 0
Blood prolactin increased 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Blood uric acid increased 0/21 (0%) 0 0/21 (0%) 0 0/20 (0%) 0 1/20 (5%) 1
Neutrophil count decreased 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 0/20 (0%) 0
Weight decreased 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Metabolism and nutrition disorders
Decreased appetite 0/21 (0%) 0 2/21 (9.5%) 2 1/20 (5%) 2 0/20 (0%) 0
Musculoskeletal and connective tissue disorders
Musculoskeletal pain 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 0/20 (0%) 0
Musculoskeletal stiffness 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Myalgia 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Nervous system disorders
Dizziness 1/21 (4.8%) 1 1/21 (4.8%) 1 1/20 (5%) 1 0/20 (0%) 0
Headache 3/21 (14.3%) 3 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Somnolence 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Tremor 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Psychiatric disorders
Affect lability 1/21 (4.8%) 2 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Affective disorder 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Agitation 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Anxiety 1/21 (4.8%) 1 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Delusion 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Depression 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Hallucination 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Restlessness 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Schizophrenia 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Reproductive system and breast disorders
Dysmenorrhoea 0/11 (0%) 0 1/10 (10%) 1 0/9 (0%) 0 0/10 (0%) 0
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Upper respiratory tract inflammation 0/21 (0%) 0 1/21 (4.8%) 1 1/20 (5%) 1 0/20 (0%) 0
Skin and subcutaneous tissue disorders
Alopecia 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 0/20 (0%) 0
Blister 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 0/20 (0%) 0
Dermatitis 0/21 (0%) 0 1/21 (4.8%) 1 0/20 (0%) 0 0/20 (0%) 0
Hair colour changes 0/21 (0%) 0 0/21 (0%) 0 1/20 (5%) 1 0/20 (0%) 0
Pruritus 0/21 (0%) 0 1/21 (4.8%) 1 2/20 (10%) 2 0/20 (0%) 0
Rash 0/21 (0%) 0 1/21 (4.8%) 1 1/20 (5%) 1 0/20 (0%) 0
Vascular disorders
Hot flush 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0
Hypertension 1/21 (4.8%) 1 0/21 (0%) 0 0/20 (0%) 0 0/20 (0%) 0

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 more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

Results Point of Contact

Name/Title Chief Medical Officer
Organization Eli Lilly and Company
Phone 800-545-5979
Email
Responsible Party:
Denovo Biopharma LLC
ClinicalTrials.gov Identifier:
NCT01125358
Other Study ID Numbers:
  • 13560
  • H8Y-JE-HBDC
First Posted:
May 18, 2010
Last Update Posted:
Sep 14, 2021
Last Verified:
Nov 1, 2012