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Phase 3 data shows lumateperone 42 mg significantly delayed relapse in patients with schizophrenia vs placebo, with 63% reduced relapse risk and good tolerance.
New phase 3 data showed that patients with schizophrenia on lumateperone (CAPLYTA) 42 mg had a significantly delayed relapse compared to patients on placebo.1 Intra-Cellular Therapies announced the positive results of Study 304, a multicenter, multi-national, randomized, double-blind, placebo-controlled, parallel-group trial, on November 5, 2024.
Lumateperone (10.5 mg, 21 mg, 42 mg), an oral, once-daily atypical antipsychotic, is approved in adults for the treatment of schizophrenia and the treatment of depressive episodes linked to bipolar disorder as a monotherapy or an adjunctive therapy with lithium or valproate.2,3 Lumateperone is believed to be mediated through a combination of antagonist activity at central serotonin 5-HT2A receptors and postsynaptic antagonist activity at central dopamine D2 receptors.
Research has indicated up to 81.9% of individuals with schizophrenia or schizoaffective disorder experience a relapse within 5 years of their diagnosis, with the global rate between 50 – 92%.4,5 Subsequent relapses also have high rates.4 A schizophrenia relapse leads not only to increases in schizophrenia symptoms but to negative life impacts such as not adhering to medication, job or legal issues, self-harm, and hospitalization.
Study 304 evaluated the efficacy and safety of lumateperone 42 mg for the prevention of symptomatic relapse in adult patients with schizophrenia.1 The 47-week trial started with an 18-week open-label phase where patients with schizophrenia were given lumateperone 42 mg per day. Participants who met the stabilization criteria during the open-label period continued to the double-blind treatment phase.
Participants were randomized to receive lumateperone 42 mg (n = 114) or placebo (n = 114) for up to 26 weeks or until a relapse. The primary endpoint was the time to the first symptom relapse, and the secondary endpoint was the time to all-cause discontinuation during the double-blind phase.
The study revealed the time to relapse during the double-blind treatment phase was significantly longer in patients receiving lumateperone compared with those receiving placebo (P = .0002). In total, 18 relapses (16.4%) occurred in the lumateperone group versus 44 relapses (38.6%) in the placebo group. Lumateperone was associated with a 63% reduction in risk of relapse compared with placebo (hazard ratio [HR], 0.37; 95% confidence interval [CI], 0.22 – 0.65).
The data shows lumateperone is generally safe and well-tolerated. During the double-blind phase, participants commonly reported headaches, observed among ≥ 5% of the sample and twice the rate of placebo. Other common adverse events observed in previous clinical trials included somnolence/sedation, dizziness, nausea, and dry mouth.
“The control of symptoms and the prevention of relapses is critical to improving long-term patient outcomes,” said Suresh Durgam, MD, executive vice president and chief medical officer of Intra-Cellular Therapies. “We are very pleased that the results from Study 304, a randomized withdrawal trial, demonstrated efficacy along with favorable safety and tolerability which support the benefit of continued long-term treatment with lumateperone.”
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