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Pentoxifylline Augmentation in Schizophrenia

Перакладаць артыкулы могуць толькі зарэгістраваныя карыстальнікі
Увайсці / Зарэгістравацца
Спасылка захоўваецца ў буферы абмену
СтатусВербаванне
Спонсары
Sadat City University

Ключавыя словы

Рэферат

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.
This study aims to examine the efficacy of pentoxifylline, the novel phosphodiesterase inhibitor, in a sample of moderately ill outpatients with early-course schizophrenia. The investigators hypothesize that as compared to placebo a 2-month treatment with pentoxifylline in 120 volunteers with early-course schizophrenia will result in a more significant improvement in psychopathology (primary outcome) and cognitive symptoms (secondary outcome). In addition, cytokine plasma levels will be used as another secondary outcome measure to see if treatment-induced changes in total PANSS score are associated with changes in cytokine levels.

Апісанне

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.

Даты

Апошняя праверка: 06/30/2020
Упершыню прадстаўлена: 09/14/2019
Меркаваная колькасць заявак прадстаўлена: 09/15/2019
Першае паведамленне: 09/17/2019
Апошняе абнаўленне адпраўлена: 07/06/2020
Апошняе абнаўленне апублікавана: 07/07/2020
Фактычная дата пачатку даследавання: 12/31/2018
Разліковая дата першаснага завяршэння: 12/29/2020
Разліковая дата завяршэння даследавання: 12/30/2020

Стан альбо хвароба

Schizophrenia

Ўмяшанне / лячэнне

Drug: Control group

Drug: Pentoxifylline group

Фаза

Фаза 1/Фаза 2

Групы ўзбраенняў

РукаЎмяшанне / лячэнне
Placebo Comparator: Control group
Equivalent Placebo will be given
Drug: Control group
Placebo tablets PLUS Risperidone 2 mg tablet up to 6 mg/day
Experimental: Pentoxifylline group
Pentoxifylline will be given orally at 1200 mg a day for 4 months
Drug: Pentoxifylline group
Pentoxifylline tablet PLUS Risperidone 2 mg tablet up to 6 mg/day

Крытэрыі прыдатнасці

Узрост, які мае права на вучобу 18 Years Каб 18 Years
Пол, прыдатны для навучанняAll
Прымае здаровых валанцёраўТак
Крытэрыі

Inclusion Criteria:

- Ages between 18-40 years

- Males & females

- Current DSM-IV diagnosis of schizophrenia or schizoaffective disorder confirmed by the Mini-International Neuropsychiatric Interview (M.I.N.I.) conducted by a trained psychiatrist.

- Treatment with a stable dose of second generation antipsychotic medication for at least 1 months prior to study entry 200-600 mg/day chlorpromazine equivalent doses);

- Evidence of stable symptomatology for 12 weeks as evidenced by no hospitalizations for schizophrenia, no increase in level of psychiatric care due to worsening of symptoms, no ER use for symptoms of schizophrenia and no significant changes to antipsychotic medication or dose (>25%) in the past 12 weeks.

- Baseline total score between 40 and 65 on the Brief Psychiatric Rating Scale (BPRS); Raw score of 12 or higher on the Wechsler Test of Adult Reading (WTAR) (estimates premorbid IQ).

- Able to comprehend the procedure and aims of the study to provide informed consent

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

Вынік

Першасныя вынікі

1. Treatment-induced change in total score on Positive and Negative Syndrome Scale (PANSS) [Baseline to week 16 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.

Меры другаснага выніку

1. Treatment-induced change in MATRICS Cognitive Consensus Battery (MCCB) [Baseline and week 16 of the study]

Average total score on MCCB will be used to examine treatment-induced change in cognitive function. MCCB (Nuechterlein et al., 2008) will be admisnitered at the baseline an week 16 of the study. The MCCB assesses 7 domains of cognitive functioning known to be impaired for individuals with schizophrenia. A summary score averaging across domains is generated as a global measure of cognitive functioning.

2. Treatment-induced changes in plasma level of cytokines [Baseline and week 16 of the study]

Cytokine levels will assessed at baseline and week 16 of the study to examine treatment-induced changes in neuroinflammation.

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