Study of immunology in antibody positive psychosis (SINAPPS)2



A randomised phase II double-blinded placebo-controlled trial of intravenous immunoglobulins and rituximab in patients with antibody-associated psychosis.


The increasing evidence of the role of antibodies and the immune system in causing symptoms of psychosis and schizophrenia is inconsistent.  


We propose that in some patients the cause of psychosis may be antibodies binding to neuronal membrane targets (NMDAR, LGI1, GABA-A and other), especially NMDA receptors, in the brain. The hypothesis underlying the SINAPPS2 trial is that these antibodies may be pathogenic and responsible for isolated psychosis (antibody-mediated psychosis).


We are conducting the SINAPPS2 trial to test if immunotherapy is an effective treatment for antibody-mediated psychosis.

SINAPPS2 is a randomised phase II double-blinded placebo-controlled trial of intravenous immunoglobulin and rituximab in patients with antibody-mediated psychosis. Adult patients (18-70 years old) with antibody-mediated psychosis are invited to one of the NHS hospitals participating in the study, where they are assessed and assisted by a team of SINAPPS2 clinicians and researchers. Eligible patients are randomly allocated to receive either intravenous immunoglobulin combined with rituximab or placebo treatment and they will be followed for at least 12 months.


Recruitment began in September 2017 and it will run until December 2021.


If you want to know more about the study procedures, click here




The SINAPPS2 trial is funded by Medical Research Council, Developmental Pathway Funding Scheme: MR/N019067/1


SINAPPS2 is a phase II ongoing clinical trial aiming to test the efficacy and safety of immunotherapy (intravenous immunoglobulin combined with rituximab) vs placebo treatment in people with acute symptoms of psychosis and anti-neuronal membrane antibodies.



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