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SchizophreniaPhase 4CASPARNCT04940039

A Study to Assess the Treatment of Schizophrenia With Paliperidone Palmitate in Rwandan Healthcare Settings

A Phase 4 study testing Risperidone 3 mg, Paliperidone Palmitate 50 mg eq. and Paliperidone Palmitate 75 mg eq. in people with Schizophrenia, run by Janssen-Cilag International NV at 5 sites in Rwanda.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to assess the long-term symptomatic response (Visit 2 [Week 1] to Visit 14/Week 66 [End of Study {EOS}]) measured by change in the Clinical Global Impressions -Severity for Schizophrenia (CGI-SS) in participants with schizophrenia who are treated in Rwandan real-world healthcare settings… Read more about this study

Who is it for?
Ages 19 to 34 years
Conditions the study is for
Schizophrenia
What is being tested?
Risperidone 3 mg, Paliperidone Palmitate 50 mg eq. and Paliperidone Palmitate 75 mg eq.
Could I receive a placebo?
No, everyone receives an active treatment
How many people
93 participants
Where
5 sitesRwanda
Study dates
22 Jul 2021to 16 Apr 2024
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 to 34 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Diagnosis of schizophrenia by Mini International Neuropsychiatric Interview (MINI)-Screen / MINI (Module K) that requires treatment initiation or a change in treatment to better address safety, efficacy, or adherence limitations of current treatment
  • Eligible for treatment in the Rwandan mental healthcare system
  • At least moderately ill as measured by the Clinical Global Impression - Severity of Schizophrenia (CGI-SS) scale for schizophrenia (rating of greater than or equal to [>=] 4). This criterion needs to be re-confirmed at Visit 2
  • Has a primary caregiver who is willing to participate in this study (caregiver should be knowledgeable about the participant's condition, provide economic/cost of care information, and is expected to be with the participant for greater than [>] 24 hours each week for the duration of the study)
  • A woman of childbearing potential must have a negative highly sensitive serum (beta-human chorionic gonadotropin [beta-hCG]) during screening
  • Able to give consent to participate in a clinical study that includes treatment with risperidone and long-acting injectable (LAI) formulations of paliperidone palmitate. Participants must be willing to receive injections. The participant and the caregiver must sign their own informed consent form (ICF) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study

Who cannot join

  • Has a physical, mental, or legal incapacity that prevents a valid consent or capacity to complete about 12 months of treatment with antipsychotic medication and compliance with this study protocol
  • History of organic brain syndromes, comorbid psychiatric and/or physical illnesses, or significant comorbid substance abuse that is likely to interfere with understanding of or compliance with study requirements
  • Known allergies, hypersensitivity, or intolerance to risperidone or paliperidone palmitate or its excipients
  • Received an investigational intervention including investigational vaccines or used an invasive investigational medical device within 30 days before the planned first dose of study intervention, or is currently enrolled in an investigational study
  • Pregnant, or breast-feeding, or planning to become pregnant while enrolled in this study or within 6 months after the last dose of study intervention
  • Poor prior response to risperidone or paliperidone

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

Rwanda5 sites
  • University Teaching Hospital of Butare(CHUB)

    Butare, NAP

  • Kibuye Referral Hospital

    Kibuye, POBOX44

  • CARAES Ndera Neuro-Psychiatric Hospital

    Kigali, 423

  • University Teaching Hospital of Kigali

    Kigali, KN4

  • Rwamagana Provincial Hospital

    Rwamagana

Other trials in Rwanda

About this study

Official title: Clinical Study to Assess the Treatment of Schizophrenia With Paliperidone Palmitate in Rwandan Healthcare Settings

The purpose of this study is to assess the long-term symptomatic response (Visit 2 [Week 1] to Visit 14/Week 66 [End of Study {EOS}]) measured by change in the Clinical Global Impressions -Severity for Schizophrenia (CGI-SS) in participants with schizophrenia who are treated in Rwandan real-world healthcare settings with the antipsychotic regimen that starts with oral anti-psychotic (AP) formulation followed by continued treatment with (paliperidone palmitate 1-month [PP1M] and 3-month [PP3M] formulations).

Conditions
Schizophrenia
Being tested
Risperidone 3 mg, Paliperidone Palmitate 50 mg eq., Paliperidone Palmitate 75 mg eq., Paliperidone Palmitate 100 mg eq., Paliperidone Palmitate 150 mg eq.
Keywords
Long-acting injectable antipsychotics, Low income countries, schizophrenia
Medical subject headings
Schizophrenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Risperidone 3 mgDrug

    Participants will receive 3 mg oral risperidone tablet once daily for 3 days.

  • Paliperidone Palmitate 50 mg eq.Drug

    Also called R092670

    Participants will receive 50 mg eq. PP1M IM injection for at least 17 weeks (maximum 25 weeks).

  • Paliperidone Palmitate 75 mg eq.Drug

    Also called R092670

    Participants will receive 75 mg eq. PP1M IM injection for at least 17 weeks.

  • Paliperidone Palmitate 100 mg eq.Drug

    Also called R092670

    Participants will receive 100 mg eq. PP1M IM injection for at least 17 weeks.

  • Paliperidone Palmitate 150 mg eq.Drug

    Also called R092670

    Participants will receive 150 mg eq. PP1M IM injection for at least 17 weeks.

  • Paliperidone Palmitate 175 mg eq.Drug

    Also called R092670

    Participants will receive 175 mg eq. PP3M IM injection up to 24 weeks.

  • Paliperidone Palmitate 263 mg eq.Drug

    Also called R092670

    Participants will receive 263 mg eq. PP3M IM injection up to 24 weeks.

  • Paliperidone Palmitate 350 mg eq.Drug

    Also called R092670

    Participants will receive 350 mg eq. PP3M IM injection up to 24 weeks.

  • Paliperidone Palmitate 525 mg eq.Drug

    Also called R092670

    Participants will receive 525 mg eq. PP3M IM injection up to 24 weeks.

Study groups in NCT04940039
Study groupRoleWhat they receive
Paliperidone PalmitateExperimentalParticipants in Observation Phase will receive their treatment prescribed by treating physicians as part of their routine clinical practice and the standard of care (SoC) treatment for Rwanda mental healthcare settings. Participants who have not received risperidone or paliperidone or paliperidone palmitate earlier in Observation Phase will receive oral risperidone 3 milligram (mg) tablets once daily for 3 days in Run-in Phase to determine tolerability. Participants will receive flexible dose range from 50 to 150 mg equivalent (eq.) long acting formulation of paliperidone palmitate once monthly (PP1M) as an intramuscular (IM) injection in Lead-in Treatment Phase for at least 17 weeks (maximum 25 weeks) and if stable dose is achieved for PP1M, participants will enter Maintenance Treatment Phase and continue to receive flexible dose range from 175 to 525 mg eq. long acting formulation of paliperidone palmitate every 3 months (PP3M) as an IM injection for up to 24 weeks.
Receives: Drug: Risperidone 3 mg; Drug: Paliperidone Palmitate 50 mg eq.; Drug: Paliperidone Palmitate 75 mg eq.; Drug: Paliperidone Palmitate 100 mg eq.; Drug: Paliperidone Palmitate 150 mg eq.; Drug: Paliperidone Palmitate 175 mg eq.; Drug: Paliperidone Palmitate 263 mg eq.; Drug: Paliperidone Palmitate 350 mg eq.; Drug: Paliperidone Palmitate 525 mg eq.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Change in Clinical Global Impression Severity of Schizophrenia (CGI-SS) Score from Visit 2 (Week 1) to Visit 14 (Week 66 [End of Study {EOS}])

    The CGI-SS will be used to provide a clinical measure of the severity of schizophrenia. It is a single-item Likert scale with a 7-point range (1 indicates none to 7 indicates extreme symptoms).

    Measured: Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

Secondary outcomes (21)
  1. Mean Change in CGI-SS Score from Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

    The CGI-SS will be used to provide a clinical measure of the severity of schizophrenia. It is a single-item Likert scale with a 7-point range (1 indicates none to 7 indicates extreme symptoms).

    Measured: Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

  2. Mean Change in CGI-SS Score from Visit 2 (Week 1) to Visit 6 (Week 25)

    The CGI-SS will be used to provide a clinical measure of the severity of schizophrenia. It is a single-item Likert scale with a 7-point range (1 indicates none to 7 indicates extreme symptoms).

    Measured: Visit 2 (Week 1) to Visit 6 (Week 25)

  3. Change in Personal and Social Performance (PSP) Scale Score from Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

    The PSP scale assesses the degree of difficulty a participant exhibits over a 7-day period within 4 domains of behavior: a) socially useful activities, b) personal and social relationships, c) self-care, and d) disturbing and aggressive behavior. The impairment of each domain is rated on a 6-point basis, including absent (0), mild (1), moderate (2), marked (3), severe (4), and very severe (5). The higher domain score, therefore, indicates, worse functioning in that area.

    Measured: Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

  4. Change in PSP Scale Scores from Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

    The PSP scale assesses the degree of difficulty a participant exhibits over a 7-day period within 4 domains of behavior: a) socially useful activities, b) personal and social relationships, c) self-care, and d) disturbing and aggressive behavior. The impairment of each domain is rated on a 6-point basis, including absent (0), mild (1), moderate (2), marked (3), severe (4), and very severe (5). The higher domain score, therefore, indicates, worse functioning in that area.

    Measured: Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

  5. Change in PSP Scale Score from Visit 2 (Week 1) to Visit 6 (Week 25)

    The PSP scale assesses the degree of difficulty a participant exhibits over a 7-day period within 4 domains of behavior: a) socially useful activities, b) personal and social relationships, c) self-care, and d) disturbing and aggressive behavior. The impairment of each domain is rated on a 6-point basis, including absent (0), mild (1), moderate (2), marked (3), severe (4), and very severe (5). The higher domain score, therefore, indicates, worse functioning in that area.

    Measured: Visit 2 (Week 1) to Visit 6 (Week 25)

  6. Change in Patient Satisfaction Rating Scale Score from Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

    The patient satisfaction rating is a 4-item scale. Two items use a Likert scale with a 6-point range (0 [very dissatisfied] to 5 [very satisfied]) and 2 items are multiple-choice (example, "select all that apply"). Higher score indicates greater satisfaction.

    Measured: Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

  7. Change in Patient Satisfaction Rating Scale Score from Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

    The patient satisfaction rating is a 4-item scale. Two items use a Likert scale with a 6-point range (0 [very dissatisfied] to 5 [very satisfied]) and 2 items are multiple-choice (example, "select all that apply"). Higher score indicates greater satisfaction.

    Measured: Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

  8. Change in Patient Satisfaction Rating Scale Score from Visit 2 (Week 1) to Visit 6 (Week 25)

    The patient satisfaction rating is a 4-item scale. Two items use a Likert scale with a 6-point range (0 [very dissatisfied] to 5 [very satisfied]) and 2 items are multiple-choice (example, "select all that apply"). Higher score indicates greater satisfaction.

    Measured: Visit 2 (Week 1) to Visit 6 (Week 25)

  9. Change in Clinician Satisfaction Rating Scale Score from Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

    The clinician satisfaction rating is a 4-item scale. Two items use a Likert scale with a 6-point range (0 [very dissatisfied] to 5 [very satisfied]) and 2 items are multiple-choice (example, "select all that apply"). Higher score indicates greater satisfaction.

    Measured: Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

  10. Change in Clinician Satisfaction Rating Scale Score from Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

    The clinician satisfaction rating is a 4-item scale. Two items use a Likert scale with a 6-point range (0 [very dissatisfied] to 5 [very satisfied]) and 2 items are multiple-choice (example, "select all that apply"). Higher score indicates greater satisfaction.

    Measured: Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

  11. Change in Clinician Satisfaction Rating Scale Score from Visit 2 (Week 1) to Visit 6 (Week 25)

    The clinician satisfaction rating is a 4-item scale. Two items use a Likert scale with a 6-point range (0 [very dissatisfied] to 5 [very satisfied]) and 2 items are multiple-choice (example, "select all that apply"). Higher score indicates greater satisfaction.

    Measured: Visit 2 (Week 1) to Visit 6 (Week 25)

  12. Change in Schizophrenia Quality of Life Scale (SQLS) Score from Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

    The SQLS has 33 items covering topics such as psychosocial feelings and vitality. Response options are never, rarely, sometimes, often, or always. Scoring algorithms yield a 0 to 100 scale, with higher scores indicating lower quality of life.

    Measured: Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])

  13. Change in SQLS Score from Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

    The SQLS has 33 items covering topics such as psychosocial feelings and vitality. Response options are never, rarely, sometimes, often, or always. Scoring algorithms yield a 0 to 100 scale, with higher scores indicating lower quality of life.

    Measured: Visit 6 (Week 25) to Visit 14 (Week 66 [EOS])

  14. Change in SQLS Score from Visit 2 (Week 1) to Visit 6 (Week 25)

    The SQLS has 33 items covering topics such as psychosocial feelings and vitality. Response options are never, rarely, sometimes, often, or always. Scoring algorithms yield a 0 to 100 scale, with higher scores indicating lower quality of life.

    Measured: Visit 2 (Week 1) to Visit 6 (Week 25)

  15. Number of Participants with Treatment-emergent Adverse Events

    An adverse event is any untoward medical occurrence in a clinical study participants administered a medicinal (investigational or non-investigational) product. An adverse event does not necessarily have a causal relationship with the intervention. Treatment-emergent adverse events are adverse events with onset after the initiation of treatment in observation phase and separately for initiation of paliperidone palmitate (PP) in Lead-in phase or that are a consequence of a pre-existing condition that has worsened after each treatment phase starts.

    Measured: Up to Week 66

  16. Number of Participants with Abnormalities in Clinical Laboratory Measures

    Number of participants with abnormalities in clinical laboratory measures (including serum chemistry, hematology and urinalysis) will be reported.

    Measured: Up to Week 66

  17. Number of Participants with Abnormalities in Vital Signs

    Number of participants with abnormalities in vital signs (temperature [oral], pulse/heart rate, and blood pressure) will be reported.

    Measured: Up to Week 66

  18. Number of Participants with Abnormalities in Electrocardiogram (ECG)

    Number of participants with abnormalities in ECG will be reported.

    Measured: Up to Week 66

  19. Number of Participants with Abnormalities in Physical Examination

    Number of participants with abnormalities in physical examination (including body weight, waist circumference, and height) will be reported.

    Measured: Up to Week 66

  20. Number of Participants With Pregnancy Outcome as a Safety Measure

    Number of participants with pregnancy outcome will be reported.

    Measured: Up to Week 66

  21. Number of Participants With Suicidal Ideation and Behavior as Assessed by Columbia Suicide Severity Rating Scale (C-SSRS) Score

    C-SSRS is an approved and standardized scale for the assessment of the severity of suicidality, through clinical interview. The maximum score assigned for each participant will be summarized into one of three categories: no suicidal ideation or behavior (0), suicidal ideation (1-5), suicidal behavior (6-10). Total score ranges from 1 to 10. Higher scores indicate greater severity. Number of participants with suicidal ideation and behavior will be reported.

    Measured: Visit 12 (Week 46) to Visit 14 (Week 66 [EOS])

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jun 2021
  2. Study start22 Jul 2021
  3. Primary completion16 Apr 2024
  4. Study completion16 Apr 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
93 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04940039
Sponsor's protocol ID
CR108924
Other IDs
R092670PSY4002
Acronym
CASPAR
Status last verified
Apr 2025
First submitted
22 Jun 2021
Last updated
27 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The data sharing policy of the Janssen Pharmaceutical Companies of Johnson \& Johnson is available at www.janssen.com/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale Open Data Access (YODA) Project site at yoda.yale.edu

Publications

  • Bizoza R, Mehawej J, Musoni-Rwililiza E, Alphs L, Turkoz I, Sun L, Killion L, Decotelli-Mendes C, Knight RK. Efficacy and safety of long-acting injectable paliperidone palmitate 1-month and 3-month formulations in the maintenance treatment of schizophrenia: a single-arm, open-label, interventional study in Rwandan healthcare settings. BMJ Open. 2026 Jun 16;16(6):e109753. doi: 10.1136/bmjopen-2025-109753.

    PubMed 42303401

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Risperidone 3 mg, Paliperidone Palmitate 50 mg eq. and Paliperidone Palmitate 75 mg eq. in people with Schizophrenia, run by Janssen-Cilag International NV at 5 sites in Rwanda.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Rwanda. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Change in Clinical Global Impression Severity of Schizophrenia (CGI-SS) Score from Visit 2 (Week 1) to Visit 14 (Week 66 [End of Study {EOS}]) (time frame: Visit 2 (Week 1) to Visit 14 (Week 66 [EOS])). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04940039, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Apr 2025.

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