Literature DB >> 21240151

A failed 6-week,randomized, double-blind, placebo-controlled study of once-daily extended release quetiapine fumarate in patients with acute schizophrenia: lessons learned.

Andrew J Cutler1, Tram Tran-Johnson, Amir Kalali, Mikael Aström, Martin Brecher, Didier Meulien.   

Abstract

OBJECTIVE: To demonstrate the efficacy of once-daily extended release quetiapine fumarate (quetiapine XR) versus placebo in adults with acute exacerbation of schizophrenia.
METHODS: A 6-week, double-blind, randomized, placebo-controlled study. In- or out-patients with a DSM-IV diagnosis of schizophrenia were randomized to fixed-dose quetiapine XR 400, 600, or 800 mg/day, quetiapine immediate release (IR) 800 mg/day, or placebo. Primary endpoint was change from baseline in Positive and Negative Syndrome Scale (PANSS) total score at Week 6. Other efficacy assessments included Clinical Global Impressions (CGI) of Severity (CGI-S) and of Improvement (CGI-I) ratings. Safety assessments included adverse event (AE) reporting and laboratory measures.
RESULTS: 565 patients were randomized; 333 (58.9%) completed the study. Greater numeric improvements in PANSS total score were seen for quetiapine XR (all doses) and quetiapine IR versus placebo at Week 6; the differences were not statistically significant. Secondary efficacy endpoint results were similar. There was not a high placebo response in this study, but rather an attenuation of drug effect. In general, quetiapine XR was well tolerated over 6-weeks' treatment; there were no unexpected AEs.
CONCLUSION: The efficacy of quetiapine XR (400, 600, and 800 mg/day) was not established at Week 6. Quetiapine IR, an agent with established efficacy in schizophrenia, also did not separate from placebo at endpoint. Therefore, this is considered a failed study and possible reasons for this are discussed. Quetiapine XR was generally well tolerated and its safety profile was consistent with the known profile of quetiapine.

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Year:  2010        PMID: 21240151

Source DB:  PubMed          Journal:  Psychopharmacol Bull        ISSN: 0048-5764


  10 in total

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2.  Placebo response in antipsychotic clinical trials: a meta-analysis.

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5.  A 6-week, double-blind, placebo- and haloperidol-controlled, phase II study of lurasidone in patients with acute schizophrenia.

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6.  Meta-analysis of Placebo Response in Randomized Clinical Trials of Antipsychotic Drugs Using PANSS Focusing on Different Approaches to the Handling of Missing Data.

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7.  Dose equivalents for second-generation antipsychotics: the minimum effective dose method.

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8.  The management of schizophrenia: focus on extended-release quetiapine fumarate.

Authors:  Joseph Peuskens
Journal:  Neuropsychiatr Dis Treat       Date:  2011-09-21       Impact factor: 2.570

9.  Update on extended release quetiapine fumarate in schizophrenia and bipolar disorders.

Authors:  Nizar El-Khalili
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10.  Examining Side Effect Variability of Antipsychotic Treatment in Schizophrenia Spectrum Disorders: A Meta-analysis of Variance.

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  10 in total

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