Open-label Study to Assess Usability of the Medical Information Device #1 (MIND1) System in Adults With Schizophrenia On Oral Aripiprazole
Study Details
Study Description
Brief Summary
The purpose of this study is to determine the usability of the Medical Information Device #1 (MIND1) system in adults with schizophrenia who are treated with oral aripiprazole.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 2 |
Detailed Description
Poor adherence to medication is a well-recognized problem in psychiatric patients. Although a variety of treatment models have been developed to improve management of patients in general and medication adherence in particular, poor medication adherence remains a major barrier to achieving optimal health.
The MIND1 System includes a drug-device combination, a patch, and application software to convey level of activity and rest and to mark events through the act of ingestion.
The purpose of this open-label study is to determine the usability of the Medical Information Device #1 (MIND1) System in adults with schizophrenia. Approximately 32 subjects with schizophrenia, between 18 and 65 years of age (inclusive) who are currently prescribed and stabilized on oral aripiprazole, will be enrolled.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: MIND1 System
|
Device: MIND1 System
Subjects will receive aripiprazole tablets embedded with an IEM. They will discontinue their normally prescribed oral aripiprazole tablets and will take the aripiprazole + IEM tablets (eg, at the previously prescribed dose) during the 8-week treatment period for this study. Aripiprazole + IEM tablets must be taken on a once-daily dosing schedule.
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Proportion of Participants Who Are Able to Pair & Apply a Patch Independently & Successfully by the End of the Week 8 Study Visit as Defined by a Score of 91 to 100 on the Subject Ability to Use System Scale - Healthcare Professional Version (SAUSS-HCP) [Baseline to Week 8]
Proportion of participants who are able to pair and apply a patch independently and successfully by the end of the Week 8 study visit (or early termination, if applicable), as defined as a score of 91 to 100 on the participant's Ability to Use System Scale - Healthcare Professional Version (SAUSS-HCP). A participant was considered to have successfully and independently applied a patch if the SAUSS-HCP was at least 91 for at least one postbaseline score.
Secondary Outcome Measures
- Proportion of Participants Able to Pair & Apply a Patch Successfully, Independently, or With Minimum Assistance, by the End of the Week 8 Study Visit, as Defined by a SAUSS-HCP Score of 71 to 100. [Baseline to Week 8]
Proportion of participants who are able to pair and apply a patch successfully, independently, or with minimum assistance, by the end of the Week 8 study visit (or early termination, if applicable), as defined by a Participant's Ability to Use System Scale - Healthcare Professional Version (SAUSS-HCP) score of 71 to 100. Participants were considered to have paired and applied a patch independently or with minimal assistance if their SAUSS-HCP score was at least 71 for at least one postbaseline score.
- Proportion of Time During the Study Period When Participants Wear Their Patches [Baseline to Week 8]
Proportion of time during the study period when participants wear their patches; the time duration of patch wearing will be calculated based on digital health data. Percentage of participants' patch wearing time was calculated as (total duration a patch was worn / trial duration) x 100.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Subjects must be prepared and able to give written (signed and dated) informed consent, which includes adherence to study requirements and restrictions before enrolling in the study. Subjects must be willing to adhere to study procedures, including troubleshooting of the MIND1 System by a third party if needed (third party will be blinded to personal health information).
-
Male and female subjects 18 to 65 years of age, inclusive, at time of informed consent.
-
Subjects who have a primary current diagnosis of schizophrenia, as defined by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Subjects may be symptomatic at screening, but must be able to be treated as outpatients.
-
Subject is cooperative, able to ingest oral medication, and willing to complete all aspects of study.
-
Subject is currently prescribed oral aripiprazole for schizophrenia at one of the following single daily doses (10, 15, 20, or 30 mg), and is deemed likely to remain on this same stable dose throughout the course of the study. Subject has not had any changes in their aripiprazole regimen or dose over the 2 weeks before screening.
-
Subject must be able and willing to carry the MIND1 System smartphone on his/her person and complete all tasks, as well as adequately operate all devices, as applicable. Caregiver or other third-party assistance can be utilized, if needed, although all subjects should be encouraged to attempt all tasks themselves.
-
Subject likely possesses the capacity to utilize the technology interfaces (eg, open and navigate software applications using the touch screen) and telephone features of a smartphone. The subject has satisfactory mobile phone reception (preferably 3 bars or more, or have Wi-Fi) at home and/or at work for study-designated wireless carrier.
-
Subject is not pregnant or breast-feeding, and does not plan to become pregnant.
-
Skin on the anterior chest just above the lower edge of the rib cage that is free of any dermatological problems (eg, dermatosis or dermatitis, open wounds, or other skin disorders such as warts, rashes, atopic dermatitis, or irritations).
Exclusion Criteria:
-
Subjects with a current DSM-5 diagnosis other than schizophrenia, including major depressive disorder, bipolar disorder, schizoaffective disorder, delirium, major neurocognitive disorder (eg, dementia), intellectual developmental disorder, or any other diagnosis that might impact the subject's ability to participate in the study. Other disorders that are not the focus of treatment and will not impact the subject's ability to participate in all aspects of the study (eg, social anxiety disorder) may be included.
-
Subjects with a current DSM-5 diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal, or histrionic personality disorder.
-
Subjects who exhibit prominent negative symptoms that, in the judgment of the investigator, will interfere with study procedures or unable to adhere with study requirements.
-
Subjects who are currently on a long-acting injectable antipsychotic.
-
Subjects who are likely to be incapable of using the MIND1 System technology, even with assistance.
-
On the Columbia-Suicide Severity Rating Scale (C-SSRS) Subjects who answer "Yes" to Suicidal Ideation Item 4 (Active Suicidal Ideation with Some Intent to Act, Without Specific Plan) and whose most recent episode meeting criteria for this C-SSRS Item 4 occurred within the last 3 months, OR Subjects who answer "Yes" on the C-SSRS Suicidal Ideation Item 5 (Active Suicidal Ideation with Specific Plan and Intent) and whose most recent episode meeting criteria for this C-SSRS Item 5 occurred within the last 3 months, OR Subjects who answer "Yes" on any of the 5 C-SSRS Suicidal Behavior Items (actual attempt, interrupted attempt, aborted attempt, preparatory acts, or behavior) and whose most recent episode meeting criteria for any of these 5 C-SSRS Suicidal Behavior Items occurred within the last 1 year, OR Subjects who, in the opinion of the investigator, present a serious risk of suicide.
-
Subject has received any investigational product within the last 30 days, including the MIND1 System (eg, subjects who participated in Cohort 1 of this study are not eligible for Cohort 2).
-
Subjects who have a history or evidence of a medical condition that would expose them to an undue risk of a significant AE or interfere with assessments of safety or usability during the course of the study, including but not limited to, hepatic, renal, respiratory, cardiovascular, endocrine, neurologic, hematologic, or immunologic disease, as determined by the clinical judgment of the investigator.
-
Subjects with epilepsy or a history of seizures (except for a single childhood febrile seizure, post traumatic seizure, alcohol withdrawal seizure, etc).
-
Subjects with a history of neuroleptic malignant syndrome or clinically significant tardive dyskinesia, as assessed by the investigator.
-
Subjects who are known to be allergic, intolerant, or unresponsive to prior treatment with aripiprazole or other quinolinones.
-
Subjects with a history of hypersensitivity to antipsychotic agents.
-
Subjects with a known allergy to adhesive tape or any pertinent components of the patch or IEM
-
Sexually active women of childbearing potential who will not commit to utilizing 2 of the approved birth control methods or who will not remain abstinent during this study and for 30 days following the last dose of study medication.
-
Sexually active males (unless sterile, defined as having had a bilateral orchiectomy) who will not commit to utilizing 2 of the approved birth control methods or who will not remain abstinent during the study and for 90 days following the last dose of study drug.
-
Subject has a current history (within the past month) of a substance use disorder (excluding tobacco) which meets DSM-5 criteria, or demonstrates a positive result on the urine drug test during screening. Subjects with a positive drug screen for drugs of abuse (excluding cannabinoids) are excluded and may not be retested or rescreened. Subjects with a positive urine drug screen resulting from use of prescription (such as opioids) or over-the-counter medications or products that, in the investigator's documented opinion, do not signal a clinical condition that would impact the safety of the subject or interpretation of the study results may continue evaluation for the study following consultation and approval by the Medical Monitor.
-
Subjects who, in the opinion of the investigator, are acutely psychotic or who exhibit symptoms currently requiring hospitalization.
-
Subjects unwilling to refrain from the use of topical products on the skin patch sites.
-
Subjects unwilling or unable to complete the evaluations included in this study, which include audio recording of the subject's voice and require the ability to distinguish colors (eg, subjects unwilling to be recorded and colorblind subjects are to be excluded from participation in this study)
-
Any subject who, in the opinion of the investigator, should not participate in the study.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Cerritos | California | United States | 90703 | |
| 2 | Garden Grove | California | United States | 92845 | |
| 3 | Oceanside | California | United States | 92056 | |
| 4 | Atlanta | Georgia | United States | 30331 | |
| 5 | Chicago | Illinois | United States | 60640 | |
| 6 | Saint Louis | Missouri | United States | 63141 |
Sponsors and Collaborators
- Otsuka Pharmaceutical Development & Commercialization, Inc.
Investigators
- Study Director: Timothy Peters-Strickland, MD, Otsuka Pharmaceutical Development & Commercialization, Inc.
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 316-14-220
Study Results
Participant Flow
| Recruitment Details | The trial was conducted in 67 participants at 6 trial sites in the United States. |
|---|---|
| Pre-assignment Detail | The trial included a screening period (≤ 2 weeks), a treatment period (8 weeks), and a safety follow-up period (2 weeks). Participants enrolled under the original version of the protocol were considered to comprise a first cohort (Cohort 1), while subjects enrolled under Amendment 1 were considered to comprise a separate second cohort (Cohort 2). |
| Arm/Group Title | MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) |
|---|---|---|
| Arm/Group Description | Participants received aripiprazole tablets embedded with an ingestible event marker (IEM). They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a Medical Data Device System (MDDS). Cohort 1 participants were enrolled under the original protocol. | Participants received aripiprazole tablets embedded with an IEM. They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a MDDS. Cohort 2 participants were enrolled under protocol amendment 1. |
| Period Title: Overall Study | ||
| STARTED | 37 | 30 |
| COMPLETED | 27 | 22 |
| NOT COMPLETED | 10 | 8 |
Baseline Characteristics
| Arm/Group Title | MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) | Total |
|---|---|---|---|
| Arm/Group Description | Participants received aripiprazole tablets embedded with an ingestible event marker (IEM). They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a Medical Data Device System (MDDS). Cohort 1 participants were enrolled under the original protocol. | Participants received aripiprazole tablets embedded with an IEM. They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a MDDS. Cohort 2 participants were enrolled under protocol amendment 1. | Total of all reporting groups |
| Overall Participants | 37 | 30 | 67 |
| Age (years) [Mean (Standard Deviation) ] | |||
| Mean (Standard Deviation) [years] |
45.8
(10.3)
|
47.6
(8.9)
|
46.6
(9.7)
|
| Sex: Female, Male (Count of Participants) | |||
| Female |
10
27%
|
7
23.3%
|
17
25.4%
|
| Male |
27
73%
|
23
76.7%
|
50
74.6%
|
Outcome Measures
| Title | Proportion of Participants Who Are Able to Pair & Apply a Patch Independently & Successfully by the End of the Week 8 Study Visit as Defined by a Score of 91 to 100 on the Subject Ability to Use System Scale - Healthcare Professional Version (SAUSS-HCP) |
|---|---|
| Description | Proportion of participants who are able to pair and apply a patch independently and successfully by the end of the Week 8 study visit (or early termination, if applicable), as defined as a score of 91 to 100 on the participant's Ability to Use System Scale - Healthcare Professional Version (SAUSS-HCP). A participant was considered to have successfully and independently applied a patch if the SAUSS-HCP was at least 91 for at least one postbaseline score. |
| Time Frame | Baseline to Week 8 |
Outcome Measure Data
| Analysis Population Description |
|---|
| The intent-to-treat (ITT) population - all participants who entered the trial and used the MIND1 system |
| Arm/Group Title | MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) |
|---|---|---|
| Arm/Group Description | Participants received aripiprazole tablets embedded with an ingestible event marker (IEM). They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a Medical Data Device System (MDDS). Cohort 1 participants were enrolled under the original protocol. | Participants received aripiprazole tablets embedded with an IEM. They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a MDDS. Cohort 2 participants were enrolled under protocol amendment 1. |
| Measure Participants | 37 | 30 |
| Number (95% Confidence Interval) [percentage of participants] |
54.1
146.2%
|
56.7
189%
|
| Title | Proportion of Participants Able to Pair & Apply a Patch Successfully, Independently, or With Minimum Assistance, by the End of the Week 8 Study Visit, as Defined by a SAUSS-HCP Score of 71 to 100. |
|---|---|
| Description | Proportion of participants who are able to pair and apply a patch successfully, independently, or with minimum assistance, by the end of the Week 8 study visit (or early termination, if applicable), as defined by a Participant's Ability to Use System Scale - Healthcare Professional Version (SAUSS-HCP) score of 71 to 100. Participants were considered to have paired and applied a patch independently or with minimal assistance if their SAUSS-HCP score was at least 71 for at least one postbaseline score. |
| Time Frame | Baseline to Week 8 |
Outcome Measure Data
| Analysis Population Description |
|---|
| ITT population - all participants who entered the trial and used the MIND1 system. |
| Arm/Group Title | MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) |
|---|---|---|
| Arm/Group Description | Participants received aripiprazole tablets embedded with an ingestible event marker (IEM). They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a Medical Data Device System (MDDS). Cohort 1 participants were enrolled under the original protocol. | Participants received aripiprazole tablets embedded with an IEM. They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a MDDS. Cohort 2 participants were enrolled under protocol amendment 1. |
| Measure Participants | 37 | 30 |
| Number (95% Confidence Interval) [percentage of participants] |
83.8
226.5%
|
80.0
266.7%
|
| Title | Proportion of Time During the Study Period When Participants Wear Their Patches |
|---|---|
| Description | Proportion of time during the study period when participants wear their patches; the time duration of patch wearing will be calculated based on digital health data. Percentage of participants' patch wearing time was calculated as (total duration a patch was worn / trial duration) x 100. |
| Time Frame | Baseline to Week 8 |
Outcome Measure Data
| Analysis Population Description |
|---|
| ITT population - all participants who entered the trial and used the MIND1 system. |
| Arm/Group Title | MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) |
|---|---|---|
| Arm/Group Description | Participants received aripiprazole tablets embedded with an ingestible event marker (IEM). They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a Medical Data Device System (MDDS). Cohort 1 participants were enrolled under the original protocol. | Participants received aripiprazole tablets embedded with an IEM. They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a MDDS. Cohort 2 participants were enrolled under protocol amendment 1. |
| Measure Participants | 37 | 30 |
| Mean (Standard Deviation) [% of time participants wore patch] |
74.4
(22.0)
201.1%
|
66.2
(27.5)
220.7%
|
Adverse Events
| Time Frame | Adverse events were collected from the time of signing the informed consent, throughout the 8 week treatment period and for 2 weeks after the last treatment. | |||
|---|---|---|---|---|
| Adverse Event Reporting Description | ||||
| Arm/Group Title | MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) | ||
| Arm/Group Description | Participants received aripiprazole tablets embedded with an ingestible event marker (IEM). They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a Medical Data Device System (MDDS). Cohort 1 participants were enrolled under the original protocol. | Participants received aripiprazole tablets embedded with an IEM. They discontinued their normally prescribed oral aripiprazole tablets and took aripiprazole + IEM tablets (eg, at the previously prescribed dose) during an 8-week treatment period. Aripiprazole + IEM tablets were taken on a once-daily dosing schedule. Participants wore a patch which received signals from the IEM and transmitted information to a MDDS. Cohort 2 participants were enrolled under protocol amendment 1. | ||
All Cause Mortality |
||||
| MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | / (NaN) | / (NaN) | ||
Serious Adverse Events |
||||
| MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 2/37 (5.4%) | 0/30 (0%) | ||
| Nervous system disorders | ||||
| Transient ischaemic attack | 1/37 (2.7%) | 0/30 (0%) | ||
| Psychiatric disorders | ||||
| Agitation | 1/37 (2.7%) | 0/30 (0%) | ||
Other (Not Including Serious) Adverse Events |
||||
| MIND1 System (Cohort 1) | MIND 1 System (Cohort 2) | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 17/37 (45.9%) | 10/30 (33.3%) | ||
| Infections and infestations | ||||
| Upper respiratory tract infection | 3/37 (8.1%) | 0/30 (0%) | ||
| Metabolism and nutrition disorders | ||||
| Increased appetitie | 0/37 (0%) | 2/30 (6.7%) | ||
| Nervous system disorders | ||||
| Somnolence | 0/37 (0%) | 2/30 (6.7%) | ||
| Skin and subcutaneous tissue disorders | ||||
| Dermatitis contact | 2/37 (5.4%) | 1/30 (3.3%) | ||
| Erythema | 2/37 (5.4%) | 2/30 (6.7%) | ||
| Pruritus | 5/37 (13.5%) | 4/30 (13.3%) | ||
| Rash | 3/37 (8.1%) | 0/30 (0%) | ||
| Rash erythematous | 2/37 (5.4%) | 0/30 (0%) | ||
| Vascular disorders | ||||
| Hypertension | 3/37 (8.1%) | 0/30 (0%) | ||
Limitations/Caveats
More Information
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
Center may publish study results but ≥ 60 days prior to any public presentation, a copy is sent to Sponsor for review and Center can delay publication for 60 days to permit Sponsor to protect its intellectual property rights or confidential information contained within the publication. The first publication is a joint publication, if Center is part of a multi-center study. Center is free to publish, if there is no multi-center publication within 18 months of completion/ termination of study.
Results Point of Contact
| Name/Title | Global Medical Affairs |
|---|---|
| Organization | Otsuka Pharmaceutical Development and Commercialization, Inc. |
| Phone | 800 562-3974 |
- 316-14-220