Pentoxifylline as an Adjunctive in Treatment of Negative Symptoms in Chronic Schizophrenia

• Sponsor: Sadat City University (Other)
• Overall Status: Active, not recruiting
• CT.gov ID: NCT04094207
• Collaborator: (none)
• Enrollment: 80
• Location: 1
• Arms: 2
• Anticipated Duration (Months): 44.9
• Patients Per Site Per Month: 1.8

Study Details

Study Description

Brief Summary

The aim of this study to evaluate the efficacy and safety of pentoxifylline, the novel phosphodiesterase inhibitor, as an adjunctive to risperidone in alleviating the negative symptoms of schizophrenia.

Condition or Disease	Intervention/Treatment	Phase
Schizophrenia	Drug: Placebo oral tablet; Drug: Pentoxifylline	Phase 1/Phase 2

Detailed Description

there is some evidence for the role of phosphodiesterase (PDE) signaling system in pathophysiology of schizophrenia making this system a potential target for therapeutic agents. PDEs are a family of enzymes that hydrolyse cyclic nucleotides and thus play a key role in regulating intracellular levels of the second messenger cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate. Pentoxifylline (PTX) is a methylated xanthine derivative and a PDE inhibitor that is FDA-approved for the treatment of patients with intermittent claudication on the basis of chronic occlusive arterial disease of the limbs. It is known to inhibit platelet aggregation, increase erythrocyte flexibility or deformability, and reduce blood viscosity. The rationale for its use in schizophrenia is that it competitively inhibits PDEs, resulting in increased cAMP levels, the activation of protein kinase A (PKA), the inhibition of IL and TNF-α synthesis, and reduced inflammation. Furthermore, there is growing evidence to support the inflammatory hypothesis of schizophrenia, the investigators will also explore whether cytokine levels mediate the response from pentoxifylline treatment.

Study Design

• Study Type: Interventional
• Actual Enrollment: 80 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Treatment
• Official Title: The Phosphodiesterase Inhibitor Pentoxifylline as an Adjunctive in Treatment of Negative Symptoms in Chronic Schizophrenia: A Proof-of-Concept, Randomized, Double-Blind, Placebo-Controlled Trial
• Actual Study Start Date: Jan 1, 2019
• Actual Primary Completion Date: Sep 30, 2021
• Anticipated Study Completion Date: Sep 30, 2022

Arms and Interventions

Arm	Intervention/Treatment
Placebo Comparator: Control group Equivalent Placebo will be given	Drug: Placebo oral tablet; Placebo tablets PLUS Risperidone 2 mg tablet up to 6 mg/day
Experimental: Pentoxifylline group Pentoxifylline will be given orally at 800 mg a day for 8 weeks	Drug: Pentoxifylline; Pentoxifylline tablet PLUS Risperidone 2 mg tablet up to 6 mg/day

Outcome Measures

Primary Outcome Measures

1. Treatment-induced change in total score on Positive and Negative Syndrome Scale (PANSS) [Baseline to week 8 of the study]

   PANSS total score will be used to examine treatment-induced change in psychaopthology. The PANSS is a 30-item rating scale used to assess symptoms of psychopathology. We will use the total PANSS score as the primary outcome measure which reflects total level of psychopathology including the positive and negative symptoms as well as general psychopathology.This measure will be administered at baseline, week 8 and week 16 of the study to assess if pentoxifylline treatment results in a significant reduction in PANSS total score as opposed to placebo.

Secondary Outcome Measures

1. Treatment-induced changes in plasma level of cytokines [Baseline and week 8 of the study]

   Cytokine levels will assessed at baseline and week 8 of the study to examine treatment-induced changes in neuroinflammation.

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 50 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Inclusion Criteria:

• Ages between 18-40 years

• Males & females

• patients between the ages of 18 and 53 who met the diagnostic criteria for schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (20), with a minimum disease duration of two years.

• stable on risperidone for a minimum of 8 weeks

• clinically stable for at least 4 weeks prior to study.

• willing to give informed consent.

• able to take medication orally.

Exclusion Criteria:

• Acute, unstable, significant or untreated medical illness beside schizophrenia;

• Pregnant or breast-feeding females;

• History of substance abuse or dependence in the past 3 months.

• Known contraindication to pentoxifylline treatment.

• Any serious or life-threatening medical conditions or neurological problem, severe extrapyramidal symptoms, history of abnormal bleeding, presence of hypothyroidism, renal disease, cardiovascular problems, rising liver transaminases to 3 times the upper limit of normal or higher

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Faculty of Medicine	Shibīn Al Kawm		Egypt

Sponsors and Collaborators

• Sadat City University

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Mahmoud Samy Abdallah, Principal Investigator, Sadat City University
• ClinicalTrials.gov Identifier: NCT04094207
• Other Study ID Numbers: 0034/2018
• First Posted: Sep 18, 2019
• Last Update Posted: May 4, 2022
• Last Verified: May 1, 2022

• Individual Participant Data (IPD) Sharing Statement: Yes
• Plan to Share IPD: Yes
• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No
• Additional relevant MeSH terms: Schizophrenia; Pentoxifylline

Study Results

No Results Posted as of May 4, 2022