Cited by 154Schizophrenia research and treatmentStatistical Methods in Clinical TrialsDementia and Cognitive Impairment Research

The FDA-NIMH-MATRICS Guidelines for clinical trial design of cognitive-enhancing drugs: what do we know 5 years later?

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Buchanan, R. W., Keefe, R. S. E., Umbricht, D., Green, M. F., Laughren, T., Marder, S. R.·2011·Schizophrenia Bulletin

Abstract

The Food and Drug Administration (FDA)-National Institute of Mental Health (NIMH)-Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) clinical trial guidelines for cognitive-enhancing drugs in schizophrenia and the MATRICS Consensus Cognitive Battery (MCCB) were designed to facilitate novel compound development in the treatment of cognitive impairments. Several studies have recently utilized the FDA-NIMH-MATRICS guidelines and MCCB and allow an evaluation of the feasibility of guideline implementation and MCCB performance. In light of the study results, we would recommend the following inclusion criteria revisions-(1) clinical status and symptom inclusion criteria: maximum allowed score for hallucinations and delusions should be increased from moderate to moderately severe and the negative symptom criterion should be dropped in phase 2 studies; (2) antipsychotic medication inclusion criteria: first-generation antipsychotics should be allowed, but only in the context of no concomitant anticholinergic agents and minimal extrapyramidal symptoms, and antipsychotic polypharmacy should be allowed in the absence of pertinent pharmacokinetic or pharmacodynamic considerations; and (3) people who use illicit substances should not be allowed in phase 1B or 2A proof-of-concept studies but may be included in phase 2B and 3 studies in which proof of effectiveness and generalizability of results become more important goals. These revisions are recommended to enhance recruitment while maintaining sufficient methodological rigor to ensure the validity of study results. The MCCB has been shown to have excellent psychometric characteristics, including reliability for multisite clinical trials, clinical relevance for real-world functioning, and possible sensitivity to behavioral treatment, and should continue to serve as the standard outcome measure for cognitive enhancement studies in schizophrenia.

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  • Based on experience from early studies that used the MATRICS clinical trial guidelines, the MATRICS investigators recommended revision of the inclusion criteria to enhance recruitment while maintaining sufficient methodological rigor.

    “Based on experience from early studies that used the MATRICS clinical trial guidelines, the MATRICS investigators recommended revision of the inclusion criteria to enhance recruitment while maintaining sufficient methodological rigor.20”
  • The MATRICS recommendation for a phase 3 registration trial to be at least 6 months remained unchanged in the recent revision.

    “The original MATRICS guidelines17 specify that a phase 3 registration trial should be of sufficient duration to show an enduring effect on cognition (ie, at least 6 months), and this recommendation remained unchanged in their recent revision.20”

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  1. Keefe R, Siu C, Fox K, et al. Test-Retest characteristics of the MATRICS Consensus Cognitive Battery in a 20-site schizo- phrenia clinical trial of R3487/MEM3454 versus placebo. Schizophr Bull. 2009;35:358-359.

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Authors
Buchanan, R. W., Keefe, R. S. E., Umbricht, D., Green, M. F., Laughren, T., & Marder, S. R.
Affiliations
  • University of Maryland, Baltimore (US)
  • Duke Medical Center (US)
  • F. Hoffmann-La Roche AG (CH)
  • University of California, Los Angeles (US)
  • United States Food and Drug Administration (US)
Corresponding author
Buchanan, R. W.
Venue
Schizophrenia Bulletin
Published
2010-04-21
Volume
37
Issue
6
Pages
1209-1217
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
OpenAlex
W2126154566
Cited by
154
References
38
Citations by year
2026: 2 · 2025: 8 · 2024: 10 · 2023: 8 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 10 · 2018: 7 · 2017: 4 · 2016: 11 · 2015: 19 · 2014: 14 · 2013: 20 · 2012: 10
FWCI
9.84
Type
journal article
Language
en
Open access
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Abbott Laboratories
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • GlaxoSmithKline
  • Sanofi
  • CHDI Foundation
  • F. Hoffmann-La Roche
  • Dainippon Sumitomo Pharma
  • H. Lundbeck A/S
  • National Institutes of Health (n01mh022006-001)
  • U.S. Public Health Service (HHSN278 200441003C)
  • National Institute of Mental Health (MH22006)
  • Cilag
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
nootropic drugs
MeSH terms
Adult, Clinical Trials as Topic, Cognition, Humans, National Institute of Mental Health (U.S.), Neuropsychological Tests, Research Design, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, United States, United States Food and Drug Administration, Guidelines as Topic, Nootropic Agents

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