Trial Outcomes & Findings for Safety, Tolerability and Efficacy of SPD503 in Treating ADHD in Children Aged 6-17 (NCT NCT00150592)

NCT ID: NCT00150592

Last Updated: 2021-06-10

Results Overview

Choice reaction time (CRT) is a computerized assessment that trains the subject in holding down a press-pad and releasing the press-pad in response to stimuli presented on the screen. The task requires the subject to react as soon as a yellow dot appears in one of five locations, and the subject must respond by lifting their hand from the press-pad. This is the reaction time (RT) and ranges from 100 to 5000 msec. Lower scores indicate better performance.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

182 participants

Primary outcome timeframe

Baseline and 6 weeks

Results posted on

2021-06-10

Participant Flow

A total of 182 subjects were enrolled. Four (4) subjects were terminated prior to receiving study medication. Thus, 178 were randomized and received study medication.

Participant milestones

Participant milestones
Measure
SPD503
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
Overall Study
STARTED
121
57
Overall Study
COMPLETED
114
54
Overall Study
NOT COMPLETED
7
3

Reasons for withdrawal

Reasons for withdrawal
Measure
SPD503
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
Overall Study
Adverse Event
4
1
Overall Study
Protocol Violation
1
0
Overall Study
Withdrawal by Subject
1
2
Overall Study
Non-compliance
1
0

Baseline Characteristics

Safety, Tolerability and Efficacy of SPD503 in Treating ADHD in Children Aged 6-17

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
SPD503
n=121 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=57 Participants
Total
n=178 Participants
Total of all reporting groups
Age, Categorical
<=18 years
121 Participants
n=93 Participants
57 Participants
n=4 Participants
178 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
>=65 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Continuous
12.6 years
STANDARD_DEVIATION 2.83 • n=93 Participants
12.8 years
STANDARD_DEVIATION 2.77 • n=4 Participants
12.6 years
STANDARD_DEVIATION 2.81 • n=27 Participants
Sex: Female, Male
Female
41 Participants
n=93 Participants
13 Participants
n=4 Participants
54 Participants
n=27 Participants
Sex: Female, Male
Male
80 Participants
n=93 Participants
44 Participants
n=4 Participants
124 Participants
n=27 Participants
Region of Enrollment
United States
121 Participants
n=93 Participants
57 Participants
n=4 Participants
178 Participants
n=27 Participants

PRIMARY outcome

Timeframe: Baseline and 6 weeks

Population: Per protocol (PP) defined as all subjects who completed the study and were deemed to be protocol-compliant.

Choice reaction time (CRT) is a computerized assessment that trains the subject in holding down a press-pad and releasing the press-pad in response to stimuli presented on the screen. The task requires the subject to react as soon as a yellow dot appears in one of five locations, and the subject must respond by lifting their hand from the press-pad. This is the reaction time (RT) and ranges from 100 to 5000 msec. Lower scores indicate better performance.

Outcome measures

Outcome measures
Measure
SPD503
n=80 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=35 Participants
Change From Baseline in Choice Reaction Time (CRT) at 6 Weeks
20.7 msec
Standard Deviation 63.11
21.9 msec
Standard Deviation 64.04

SECONDARY outcome

Timeframe: Baseline and 6 weeks

Population: PP

The Digital Symbol Substitution Task/Coding Test (DSST/Coding) assesses relative contributions of speed, memory, and visual scanning. Subjects are required to copy symbols that are paired with simple geometric shapes or numbers within a specific time. Scores range from 0-65 in age category 6-7 years and 0-199 in age category 8-17 years. Higher scores indicate better performance.

Outcome measures

Outcome measures
Measure
SPD503
n=77 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=34 Participants
Change From Baseline in Digital Symbol Substitution Task/Coding Test (DSST/Coding) Scores at 6 Weeks in Age Category 8-17 Years
18.3 Units on a scale
Standard Deviation 14.03
20.7 Units on a scale
Standard Deviation 17.18

SECONDARY outcome

Timeframe: Baseline and 6 weeks

Population: PP

The Digital Symbol Substitution Task/Coding Test (DSST/Coding) assesses relative contributions of speed, memory, and visual scanning. Subjects are required to copy symbols that are paired with simple geometric shapes or numbers within a specific time. Scores range from 0-65 in age category 6-7 years and 0-199 in age category 8-17 years. Higher scores indicate better performance.

Outcome measures

Outcome measures
Measure
SPD503
n=3 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=1 Participants
Change From Baseline in DSST/Coding Scores at 6 Weeks in Age Category 6-7 Years
1.9 Units on a scale
Standard Deviation 1.95
9.7 Units on a scale
Standard Deviation 0

SECONDARY outcome

Timeframe: Baseline and 6 weeks

Population: PP

The Spatial Working Memory (SWM) Test is a computerized assessment of working memory and strategy performance. The subject is required to find blue "tokens" in various displayed boxes and use the "tokens" to fill a column on the right side of the screen. Subjects can only find "tokens" in new boxes, therefore they must remember where previous "tokens" were found. SWM scores including number of between errors, number of within errors, and number of double errors range 0-800 and SWM strategy scores range 8-56. Lower scores indicate better performance.

Outcome measures

Outcome measures
Measure
SPD503
n=80 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=35 Participants
Change From Baseline in Spatial Working Memory (SWM) Scores at 6 Weeks
Between errors
-4.4 Units on a scale
Standard Deviation 7.42
-3.2 Units on a scale
Standard Deviation 6.75
Change From Baseline in Spatial Working Memory (SWM) Scores at 6 Weeks
Within errors
0.0 Units on a scale
Standard Deviation 1.11
-0.1 Units on a scale
Standard Deviation 0.73
Change From Baseline in Spatial Working Memory (SWM) Scores at 6 Weeks
Double errors
-0.0 Units on a scale
Standard Deviation 0.69
0.1 Units on a scale
Standard Deviation 0.53
Change From Baseline in Spatial Working Memory (SWM) Scores at 6 Weeks
Strategy
-0.9 Units on a scale
Standard Deviation 2.74
-0.1 Units on a scale
Standard Deviation 2.56

SECONDARY outcome

Timeframe: Baseline and 6 weeks

Population: Full Analysis Set (FAS) defined as all subjects who received at least one dose of investigational product.

Change in the Attention Deficit Hyperactivity Disorder Rating Scale-fourth edition (ADHD-RS-IV) total score from baseline. The ADHD-RS-IV consists of 18 items scored on a 4-point scale ranging from 0 (no symptoms) to 3 (severe symptoms) with total score ranging from 0 to 54.

Outcome measures

Outcome measures
Measure
SPD503
n=121 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=57 Participants
Change From Baseline in Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS-IV) Total Score at 6 Weeks
-8.8 Units on a Scale
Standard Deviation 5.98
-5.5 Units on a Scale
Standard Deviation 7.23

SECONDARY outcome

Timeframe: 6 weeks

Population: FAS

Clinical Global Impression-Improvement (CGI-I) consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement is defined as a score of 1 (very much improved) or 2 (much improved) on the scale.

Outcome measures

Outcome measures
Measure
SPD503
n=121 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=57 Participants
Number of Participants With Improvement in Clinical Global Impression-Improvement (CGI-I) at 6 Weeks
67 Participants
20 Participants

SECONDARY outcome

Timeframe: Baseline and 6 weeks

Population: FAS

The Pediatric Daytime Sleepiness Scale (PDSS) is an 8 question questionnaire scored on a scale from 0 (never) to 4 (always). Total scores range from 0 to 32, with increasing score reflecting greater sleepiness.

Outcome measures

Outcome measures
Measure
SPD503
n=121 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=57 Participants
Change From Baseline in Pediatric Daytime Sleepiness Scale (PDSS) Scores at 6 Weeks
-1.3 Units on a Scale
Standard Deviation 5.36
0.9 Units on a Scale
Standard Deviation 5.31

SECONDARY outcome

Timeframe: Baseline and 6 weeks

Population: FAS

The Pictorial Sleepiness Scale (PSS) scores range from 1 (far left wide awake face) to 5 (far right very sleepy face). Increasing score reflects greater sleepiness.

Outcome measures

Outcome measures
Measure
SPD503
n=121 Participants
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=57 Participants
Change From Baseline in Pictorial Sleepiness Scale (PSS) Scores at 6 Weeks
0.0 Units on a Scale
Standard Deviation 0.61
0.1 Units on a Scale
Standard Deviation 0.63

Adverse Events

SPD503

Serious events: 2 serious events
Other events: 96 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 32 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
SPD503
n=121 participants at risk
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=57 participants at risk
Respiratory, thoracic and mediastinal disorders
Asthma exacerbation
0.83%
1/121
0.00%
0/57
Injury, poisoning and procedural complications
Moderate loss of consciousness
0.83%
1/121
0.00%
0/57

Other adverse events

Other adverse events
Measure
SPD503
n=121 participants at risk
Subjects received either 1, 2, or 3 mg once-daily of SPD503 (Guanfacine hydrochloride) for 6 weeks.
Placebo
n=57 participants at risk
Ear and labyrinth disorders
Ear pain
3.3%
4/121
0.00%
0/57
Gastrointestinal disorders
Abdominal pain
5.0%
6/121
1.8%
1/57
Gastrointestinal disorders
Abdominal pain upper
8.3%
10/121
3.5%
2/57
Gastrointestinal disorders
Dry mouth
2.5%
3/121
0.00%
0/57
Gastrointestinal disorders
Vomiting
5.0%
6/121
1.8%
1/57
General disorders
Fatigue
5.0%
6/121
0.00%
0/57
General disorders
Non-cardiac chest pain
2.5%
3/121
0.00%
0/57
General disorders
Pyrexia
2.5%
3/121
0.00%
0/57
Nervous system disorders
Headache
24.8%
30/121
19.3%
11/57
Nervous system disorders
Sedation
7.4%
9/121
5.3%
3/57
Nervous system disorders
Somnolence
41.3%
50/121
22.8%
13/57
Psychiatric disorders
Insomnia
2.5%
3/121
1.8%
1/57
Psychiatric disorders
Irritability
5.0%
6/121
0.00%
0/57
Reproductive system and breast disorders
Dysmenorrhea
2.5%
3/121
0.00%
0/57

Additional Information

Study Director

Shire

Phone: +1 866 842 5335

Results disclosure agreements

  • Principal investigator is a sponsor employee If a multicenter publication is not submitted within twelve (12) months after conclusion, abandonment or termination of the Study at all sites, or after Sponsor confirms there shall be no multicenter Study publication, the Institution and/or such Principal Investigator may publish the results from the Institution site individually.
  • Publication restrictions are in place

Restriction type: OTHER