title: A Double-Blind, Placebo-Controlled Comparator Study of LY2140023 monohydrate in patients with schizophrenia.
abstract: BACKGROUND
  Pomaglumetad methionil (LY2140023 monohydrate) is a potent and highly selective agonist for the metabotropic glutamate mGluR2 and mGluR3 receptors. We present results of a pivotal clinical study H8Y-MC-HBBM assessing the efficacy of LY2140023 in improving symptoms as a monotherapy in patients with an acute exacerbation of schizophrenia.
  
  
  METHODS
  Enrolled adult patients (ages 18-65) with schizophrenia who had experienced an exacerbation of symptoms within 2 weeks prior to study entry. Patients (N = 1013) were randomized 2:2:2:1 to treatment with placebo, LY40 mg twice daily (BID), LY80 mg BID, or risperidone (RIS) 2 mg BID for 6 weeks after a one-week blinded placebo lead-in. The primary outcome assessed change from baseline in the Positive and Negative Syndrome Scale (PANSS) total score in an overall schizophrenia population and a predefined subpopulation which excluded non-Hispanic white patients with the A/A genotype at the HTR2A SNP rs7330461.
  
  
  RESULTS
  Neither LY2140023 dose showed significant improvement compared to placebo on PANSS total in either population (1-sided p-value [significance level], overall: LY40, p = .154 [0.01]; LY80, p = .698 [0.01], subpopulation: LY40, p = .033 [0.0025]; LY80, p = .659 [0.0025], MMRM analysis). RIS statistically separated from placebo in both populations (p < .001 [0.05]). There were no statistically significant differences in the incidence of serious adverse events, and no seizures on LY2140023.
  
  
  CONCLUSIONS
  LY2140023 treatment did not demonstrate efficacy in populations studied. Overall, LY2140023 treatment was generally well tolerated with no new adverse safety findings compared to previous trials. Further understanding of the role of glutamate as a therapeutic target in schizophrenia is needed.
  
  
  BACKGROUND
  A Phase 2, Multicenter, Double-Blind, Placebo-Controlled Comparator Study of 2 Doses of LY2140023 Versus Placebo in Patients With DSM-IV-TR SchizophreniaClinicalTrials.gov identifier: NCT01086748.
authors.affiliation: Eli Lilly and Company, Indianapolis 46285, Indiana, USA. downing_anncatherine_m@lilly.com.
authors.forename: AnnCatherine M
authors.initials: AM
authors.lastname: Downing
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Kinon
authors.forename: Brian A
authors.initials: BA
authors.lastname: Millen
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
authors.forename: Margarita A
authors.initials: MA
authors.lastname: Morozova
authors.forename: Ronald
authors.initials: R
authors.lastname: Brenner
authors.forename: Tami Jo
authors.initials: TJ
authors.lastname: Rayle
authors.forename: Laura
authors.initials: L
authors.lastname: Nisenbaum
authors.forename: Fangyi
authors.initials: F
authors.lastname: Zhao
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Gomez
mesh_terms: D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage*; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D018492:Dopamine Antagonists / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018094:Receptors, Metabotropic Glutamate / Q000819:agonists; D018967:Risperidone / Q000008:administration & dosage; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000596:Amino Acids; D014150:Antipsychotic Agents; D018492:Dopamine Antagonists; C534551:LY 2140023; D018094:Receptors, Metabotropic Glutamate; C108822:metabotropic glutamate receptor 2; C102718:metabotropic glutamate receptor 3; D018967:Risperidone