A Phase 2 interventional study of Placebo and GWP42003 in Schizophrenia and Schizophrenia-related Psychotic Disorder, sponsored by Jazz Pharmaceuticals. Completed at 15 sites in 3 countries. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2022-09-28.
Sponsored by Jazz Pharmaceuticals · Phase 2, Interventional, and Treatment
A study to compare the change in symptom severity in participants with schizophrenia or related psychotic disorder when treated with GWP42003 or placebo in conjunction with existing anti-psychotic therapy over a period of six weeks.
This eight-week (six-week treatment period and two-week follow-up), multi-centre, double-blind, randomized, placebo-controlled, parallel group study aimed to determine the efficacy, safety and tolerability of GWP42003 in participants with schizophrenia or a related psychotic disorder.
Eligible participants entered the study at a Screening and Randomization Visit (Day 1), where eligibility was established. Once all inclusion and exclusion criteria were reviewed, participants were randomized to receive either GWP42003 or placebo in conjunction with their prescribed anti-psychotic medications and began treatment on Day 1 as instructed. Assessments were performed on Days 8, 22, and 43. A safety follow-up visit was conducted on Day 57.
3,471 studies on the registry are indexed under Schizophrenia; 472 are open to participants now.
This study's enrollment of 88 is above the median of 70 across 2,872 interventional studies indexed under Schizophrenia.
Browse Schizophrenia studies →Jazz Pharmaceuticals is the lead sponsor of 167 studies on the registry; 20 are open to participants now.
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Exclusion Criteria (any of the following):
Participant presented with a current clinical picture and/or history that is consistent with:
i. delirium or dementia. ii. acute drug induced psychosis. iii. bipolar disorder.
Participants received GWP42003 (100 mg/milliliter \[mL\]), 5 mL twice daily (BID) administered orally, 5 mL in the morning and 5 mL in the evening for 6 weeks.
Drug: GWP42003
Participants received placebo (0 mL cannabidiol \[CBD\]), volume matched to the 5 mL BID dose level, administered orally, 5 mL in the morning and 5 mL in the evening for 6 weeks.
Drug: Placebo
Placebo oral solution (0 milligrams \[mg\]/mL CBD) contained the excipients sesame oil, ethanol, sucralose, and strawberry flavoring.
Also known as: Placebo control
GWP42003 was an oral solution containing 100 mg/mL CBD dissolved in the excipients sesame oil, ethanol, sucralose and strawberry flavoring.
Also known as: Cannabidiol
Change From Baseline To End Of Treatment (Day 43) In Positive And Negative Syndrome Scale (PANSS) Total Score
The PANSS was a 30-item medical scale completed by a trained rater that assessed the positive and negative symptoms of schizophrenia as well as symptoms of general psychopathology. The PANSS Total score was derived from the sum of the 30 items, which were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total score is the summed total for each of the PANSS positive symptom ('P'), negative symptom ('N'), general psychopathology symptom ('G') scores and could range from 30 to 210 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
Time frame: Day 1 through Day 43
Percentage Of PANSS Total Score Responders At End Of Treatment (Day 43)
The percentage of PANSS treatment responders, defined as participants with ≥20% improvement in PANSS Total score between baseline and End of Treatment, is presented. The percentage of participants was calculated by dividing the number of participants with a ≥20% improvement in PANSS Total score (yes) by the total number of participants.
Time frame: Day 1 through Day 43
Change From Baseline To The End Of Treatment (Day 43) In PANSS 'P' Score
The PANSS 'P' scale measured the severity of positive symptoms, including delusions, conceptual disorganization, hallucinations, hyperactivity, grandiosity, suspiciousness/persecution, and hostility. Individual items were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total 'P' score could range from 7 to 49 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
Time frame: Day 1 through Day 43
Change From Baseline To The End Of Treatment (Day 43) In PANSS 'N' Score
The PANSS 'N' scale measured the severity of negative symptoms, including blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation, and stereotyped thinking. Individual items were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total 'N' score could range from 7 to 49 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
Time frame: Day 1 through Day 43
Change From Baseline To The End Of Treatment (Day 43) In PANSS 'G' Score
The PANSS 'G' scale measured the severity of general psychopathology symptoms, including somatic concern, anxiety, guilt feelings, tension, mannerisms and posturing, depression, motor retardation, uncooperativeness, unusual thought content, disorientation, poor attention, lack of judgement and insight, disturbance of violation, poor impulse control, preoccupation, and active social avoidance. Individual items were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total 'G' score could range from 16 to 112 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
Time frame: Day 1 through Day 43
Change From Baseline To The End Of Treatment (Day 43) In The Scale For The Assessment Of Negative Symptoms (SANS)
The SANS assessed 5 symptom complexes to obtain clinical ratings of negative symptoms in participants with schizophrenia or related psychotic disorder. Symptom complexes were affective blunting, alogia (impoverished thinking), avolition/apathy, anhedonia/asociality, and disturbance of attention. Assessments were conducted on a 6-point scale (0 = not at all; 5 = severe). The total score could range from 0 to 125 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
Time frame: Day 1 through Day 43
Change From Baseline To The End Of Treatment (Day 43) In The Clinical Global Impression Severity Scale (CGI-S)
The CGI-S was a 7-point scale that required the clinician to rate the severity of a participant's illness at the time of assessment, relative to the clinician's past experience of participants who had the same diagnosis. Considering total clinical experience, participants were assessed on severity of mental illness at the time of rating on the following scale: 1 = normal, not at all ill; 2 = borderline mentally ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; or 7 = extremely ill. Lower scores equated to milder severity of symptoms, that is, closer to psychologically normal.
Time frame: Day 1 through Day 43
Clinical Global Impression Improvement Scale (CGI-I) Values At Day 8 And End Of Treatment (Day 43)
The CGI-I was a 7-point scale that required the clinician to assess how much a participant's illness had improved or worsened relative the first assessment at the beginning of the intervention. This was rated on the following scale: 1 = very much improved; 2 = much improved; 3 = minimally improved; 4 = no change; 5 = minimally worse; 6 = much worse; or 7 = very much worse. Lower scores equated to improvement of symptoms.
Time frame: Day 8 through Day 43
Change From Baseline To The End Of Treatment (Day 43) In Brief Assessment Of Cognition In Schizophrenia (BACS) Score
The BACS was an instrument used to assess the aspects of cognition found to be most impaired and most strongly correlated with outcome in participants with schizophrenia or related psychotic disorder. The BACS consisted of 6 domains: verbal memory (score range 0 to 75), working memory (score range 0 to 28), motor speed (score range 0 to 100), verbal fluency (score \> 0, with no set maximum value), attention and speed of information processing (score range 0 to 110), and executive functions (score range 0 to 22). A score was obtained for each of the 6 domains. A composite summary score was then calculated as the arithmetic mean of the unweighted scores from the 6 domains. While there was not an upper limit on the composite score, overall, an increase in score was indicative of an improvement in cognition.
Time frame: Day 1 through Day 43
| Milestone | GWP42003 1000 Milligram (mg)/Day | Placebo |
|---|---|---|
| Started | 43 | 45 |
| Received at least 1 dose of study drug | 43 | 45 |
| Intention to treat (itt) analysis set | 42 | 44 |
| Completed | 40 | 43 |
| Not completed | 3 | 2 |
| Withdrew: Adverse event | 1 | 1 |
| Withdrew: Withdrawal by subject | 2 | 1 |
The PANSS was a 30-item medical scale completed by a trained rater that assessed the positive and negative symptoms of schizophrenia as well as symptoms of general psychopathology. The PANSS Total score was derived from the sum of the 30 items, which were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total score is the summed total for each of the PANSS positive symptom ('P'), negative symptom ('N'), general psychopathology symptom ('G') scores and could range from 30 to 210 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Baseline score | 79.3 ± 12.45 | 80.6 ± 14.90 |
| End of Treatment score | 68.1 ± 14.79 | 71.9 ± 15.49 |
| Change from baseline | -11.2 ± 7.87 | -8.8 ± 8.87 |
The percentage of PANSS treatment responders, defined as participants with ≥20% improvement in PANSS Total score between baseline and End of Treatment, is presented. The percentage of participants was calculated by dividing the number of participants with a ≥20% improvement in PANSS Total score (yes) by the total number of participants.
| Participants | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Yes | 12 | 6 |
| No | 30 | 38 |
The PANSS 'P' scale measured the severity of positive symptoms, including delusions, conceptual disorganization, hallucinations, hyperactivity, grandiosity, suspiciousness/persecution, and hostility. Individual items were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total 'P' score could range from 7 to 49 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Baseline score | 18.0 ± 3.89 | 17.5 ± 3.29 |
| End of Treatment score | 14.8 ± 4.01 | 15.7 ± 3.73 |
| Change from Baseline | -3.2 ± 2.60 | -1.7 ± 2.76 |
The PANSS 'N' scale measured the severity of negative symptoms, including blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation, and stereotyped thinking. Individual items were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total 'N' score could range from 7 to 49 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Baseline score | 22.6 ± 5.04 | 23.4 ± 5.11 |
| End of Treatment score | 19.9 ± 5.32 | 20.5 ± 5.22 |
| Change from Baseline | -2.7 ± 3.55 | -2.9 ± 3.06 |
The PANSS 'G' scale measured the severity of general psychopathology symptoms, including somatic concern, anxiety, guilt feelings, tension, mannerisms and posturing, depression, motor retardation, uncooperativeness, unusual thought content, disorientation, poor attention, lack of judgement and insight, disturbance of violation, poor impulse control, preoccupation, and active social avoidance. Individual items were rated on a 7-point scale, where 1 = absent and 7 = extreme. The total 'G' score could range from 16 to 112 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Baseline score | 38.7 ± 6.71 | 39.7 ± 8.95 |
| End of Treatment score | 33.4 ± 7.69 | 35.6 ± 9.04 |
| Change from Baseline | -5.3 ± 4.34 | -4.1 ± 4.78 |
The SANS assessed 5 symptom complexes to obtain clinical ratings of negative symptoms in participants with schizophrenia or related psychotic disorder. Symptom complexes were affective blunting, alogia (impoverished thinking), avolition/apathy, anhedonia/asociality, and disturbance of attention. Assessments were conducted on a 6-point scale (0 = not at all; 5 = severe). The total score could range from 0 to 125 points, with lower scores equating to milder severity of symptoms, that is, closer to psychologically normal.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Baseline score | 52.8 ± 17.10 | 55.3 ± 16.24 |
| End of Treatment score | 43.6 ± 16.54 | 48.4 ± 15.75 |
| Change from Baseline | -9.1 ± 13.09 | -6.3 ± 8.54 |
The CGI-S was a 7-point scale that required the clinician to rate the severity of a participant's illness at the time of assessment, relative to the clinician's past experience of participants who had the same diagnosis. Considering total clinical experience, participants were assessed on severity of mental illness at the time of rating on the following scale: 1 = normal, not at all ill; 2 = borderline mentally ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; or 7 = extremely ill. Lower scores equated to milder severity of symptoms, that is, closer to psychologically normal.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Baseline score | 4.0 ± 0.70 | 4.0 ± 0.65 |
| End of Treatment score | 3.5 ± 1.09 | 3.8 ± 0.78 |
| Change from Baseline | -0.5 ± 0.74 | -0.3 ± 0.49 |
The CGI-I was a 7-point scale that required the clinician to assess how much a participant's illness had improved or worsened relative the first assessment at the beginning of the intervention. This was rated on the following scale: 1 = very much improved; 2 = much improved; 3 = minimally improved; 4 = no change; 5 = minimally worse; 6 = much worse; or 7 = very much worse. Lower scores equated to improvement of symptoms.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Day 8 score | 3.6 ± 0.50 | 3.8 ± 0.56 |
| End of Treatment score | 2.9 ± 0.89 | 3.4 ± 0.87 |
The BACS was an instrument used to assess the aspects of cognition found to be most impaired and most strongly correlated with outcome in participants with schizophrenia or related psychotic disorder. The BACS consisted of 6 domains: verbal memory (score range 0 to 75), working memory (score range 0 to 28), motor speed (score range 0 to 100), verbal fluency (score \> 0, with no set maximum value), attention and speed of information processing (score range 0 to 110), and executive functions (score range 0 to 22). A score was obtained for each of the 6 domains. A composite summary score was then calculated as the arithmetic mean of the unweighted scores from the 6 domains. While there was not an upper limit on the composite score, overall, an increase in score was indicative of an improvement in cognition.
| score on a scale | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| Baseline score | 32.21 ± 6.042 | 32.91 ± 7.158 |
| End of Treatment score | 35.73 ± 6.981 | 35.05 ± 7.310 |
| Change from Baseline | 3.48 ± 3.031 | 2.14 ± 3.442 |
Collected over Day 1 through Day 57. Non-serious events are listed at a 4% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| GWP42003 1000 mg/Day | — | 0/43 (0%) | 8/43 (18.6%) |
| Placebo | — | 1/45 (2.2%) | 10/45 (22.2%) |
| Event | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| SchizophreniaPsychiatric disorders | 0/43 | 1/45 |
| Event | GWP42003 1000 mg/Day | Placebo |
|---|---|---|
| DiarrhoeaGastrointestinal disorders | 4/43 | 2/45 |
| HeadacheNervous system disorders | 3/43 | 4/45 |
| NauseaGastrointestinal disorders | 3/43 | 0/45 |
| SomnolenceNervous system disorders | 0/43 | 3/45 |
| InsomniaPsychiatric disorders | 0/43 | 2/45 |
Safety analysis set: Participants who provided informed consent, were randomized to 1 of the treatment groups, and took at least 1 dose of investigational medicinal product (IMP).
| Age, Continuous(years) | GWP42003 1000 mg/Day | Placebo | Total |
|---|---|---|---|
| Mean | 40.9 ± 12.49 | 40.8 ± 11.00 | 40.8 ± 11.69 |
| Sex: Female, Male(Participants) | GWP42003 1000 mg/Day | Placebo | Total |
|---|---|---|---|
| Female | 15 | 22 | 37 |
| Male | 28 | 23 | 51 |
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