Trial Outcomes & Findings for Study to Evaluate the Efficacy and Quality of Life of Long-Acting Methylphenidate in Adults With Attention Deficit Hyperactivity Disorder (ADHD) (NCT NCT00783835)

NCT ID: NCT00783835

Last Updated: 2013-07-23

Results Overview

Adult ASRS assesses 18 core ADHD symptoms corresponding to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic symptoms for adult participant based on the participant's own rating for each of the symptoms using a 4 point scale (0=none, 1=mild, 2=moderate, 3=severe). If a single item is missing the score is imputed and if more than one item is missing, the total score is treated as missing. The ASRS total score is derived by summing the score assigned to each of the 18 symptoms (low=0, high=54, a higher score signifies a greater severity of symptoms).

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

60 participants

Primary outcome timeframe

Baseline and Week 4

Results posted on

2013-07-23

Participant Flow

Participant milestones

Participant milestones
Measure
Methylphenidate
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Overall Study
STARTED
60
Overall Study
COMPLETED
50
Overall Study
NOT COMPLETED
10

Reasons for withdrawal

Reasons for withdrawal
Measure
Methylphenidate
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Overall Study
Adverse Event
3
Overall Study
Medical Criteria
1
Overall Study
Withdrawal by Subject
2
Overall Study
Lost to Follow-up
1
Overall Study
Participant not Adherent
3

Baseline Characteristics

Study to Evaluate the Efficacy and Quality of Life of Long-Acting Methylphenidate in Adults With Attention Deficit Hyperactivity Disorder (ADHD)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Methylphenidate
n=60 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Age Continuous
31.1 Years
STANDARD_DEVIATION 9.6 • n=5 Participants
Sex: Female, Male
Female
20 Participants
n=5 Participants
Sex: Female, Male
Male
40 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and Week 4

Population: Intent to treat efficacy evaluation (ITTe) included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

Adult ASRS assesses 18 core ADHD symptoms corresponding to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic symptoms for adult participant based on the participant's own rating for each of the symptoms using a 4 point scale (0=none, 1=mild, 2=moderate, 3=severe). If a single item is missing the score is imputed and if more than one item is missing, the total score is treated as missing. The ASRS total score is derived by summing the score assigned to each of the 18 symptoms (low=0, high=54, a higher score signifies a greater severity of symptoms).

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Baseline in Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) Total Score at Week 4
Baseline
52.6 Unit on a scale
Standard Error 1.6
Change From Baseline in Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) Total Score at Week 4
Change at Week 4
-10.9 Unit on a scale
Standard Error 1.6

PRIMARY outcome

Timeframe: Baseline and Week 8

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

Adult ASRS assesses 18 core ADHD symptoms corresponding to DSM-IV diagnostic symptoms for adult participant based on the participant's own rating for each of the symptoms using a 4 point scale (0=none, 1=mild, 2=moderate, 3=severe). If a single item is missing the score is imputed and if more than one item is missing, the total score is treated as missing. The ASRS total score is derived by summing the score assigned to each of the 18 symptoms (low=0, high=54, a higher score signifies a greater severity of symptoms).

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Baseline in Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) Total Score at Week 8
-16.2 Unit on a scale
Standard Error 1.6

PRIMARY outcome

Timeframe: Baseline and Week 12

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

Adult ASRS assesses 18 core ADHD symptoms corresponding to DSM-IV diagnostic symptoms for adult participant based on the participant's own rating for each of the symptoms using a 4 point scale (0=none, 1=mild, 2=moderate, 3=severe). If a single item is missing the score is imputed and if more than one item is missing, the total score is treated as missing. The ASRS total score is derived by summing the score assigned to each of the 18 symptoms (low=0, high=54, a higher score signifies a greater severity of symptoms).

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Baseline in Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) Total Score at Week 12
-20.6 Unit on a scale
Standard Error 1.7

PRIMARY outcome

Timeframe: Baseline and Week 4

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

The AAQoL is a validated 29-item scale consisting of 4 subscales:life productivity (11 items), psychological health (6 items), life outlook (7 items) and relationships (5 items). Participants rate each item on a 5-point Likert - like scale ranging from 1 (not at all/never) to 5 (extremely/very often). These scores are then transformed to a 0-100 point scale, higher scores indicating better quality of life. Total score=average of individual 29 item scores (range= 0-100, where higher total score indicates better quality of life). Change from baseline in total score for AAQoL is reported.

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Score at Week 4
Baseline
39.6 Unit on a scale
Standard Error 2.1
Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Score at Week 4
Change at Week 4
19.4 Unit on a scale
Standard Error 2.3

PRIMARY outcome

Timeframe: Baseline and Week 12

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

The AAQoL is a validated 29-item scale consisting of 4 subscales:life productivity (11 items), psychological health (6 items), life outlook (7 items) and relationships (5 items). Participants rate each item on a 5-point Likert - like scale ranging from 1 (not at all/never) to 5 (extremely/very often). These scores are then transformed to a 0-100 point scale, higher scores indicating better quality of life. Total score=average of individual 29 item scores (range= 0-100, where higher total score indicates better quality of life). Change from baseline in total score for AAQoL is reported.

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Score at Week 12
21.9 Unit on a scale
Standard Error 2.3

SECONDARY outcome

Timeframe: Screening (Week -2), 4, 8 and 12

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

The CGI-S rating scale is a 7 point global assessment that measures the clinician's impression of the severity of illness exhibited by a participant. A rating of 1 = "Normal, not at all ill" and a rating of 7 = "Among the most extremely ill participants". Higher scores indicate worsening.

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Screening in Clinical Global Impression-Severity of Illness (CGI-S) Score at Weeks 4, 8 and 12
Screening (Week -2)
4.6 Unit on a scale
Standard Error 0.1
Change From Screening in Clinical Global Impression-Severity of Illness (CGI-S) Score at Weeks 4, 8 and 12
Change at Week 4
-1.0 Unit on a scale
Standard Error 0.1
Change From Screening in Clinical Global Impression-Severity of Illness (CGI-S) Score at Weeks 4, 8 and 12
Change at Week 8
-1.3 Unit on a scale
Standard Error 0.1
Change From Screening in Clinical Global Impression-Severity of Illness (CGI-S) Score at Weeks 4, 8 and 12
Change at Week 12
-1.7 Unit on a scale
Standard Error 0.1

SECONDARY outcome

Timeframe: Week 4, 8 and 12

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

The CGI-I is a 7-point scale that requires the clinician to assess how much the participant's illness has improved or worsened relative to a baseline state at the beginning of the intervention and rated as (1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse).

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Clinical Global Impression-Improvement (CGI-I) Score
Week 4
2.7 Unit on a scale
Standard Error 0.1
Clinical Global Impression-Improvement (CGI-I) Score
Week 8
2.4 Unit on a scale
Standard Error 0.1
Clinical Global Impression-Improvement (CGI-I) Score
Week 12
2.2 Unit on a scale
Standard Error 0.1

SECONDARY outcome

Timeframe: Baseline, Week 4, 8 and 12

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

The STAI scale consists of total 40 items on separate scales measuring state (20 items) and trait (20 items) anxiety. The participant reports how they feel right now at this moment for state anxiety and how they generally feel for trait anxiety. The state items are scored as: 1 (not at all), 2 (somewhat true), 3 (moderately true), 4 (very true). The trait items are scored as: 1 (almost never), 2 (sometimes), 3 (often), 4 (almost always). The total scores range from 4-80 for each scale. Higher scores indicate more impaired participants.

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
State Anxiety Score: Baseline
50.4 Unit on a scale
Standard Error 1.4
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
Trait Anxiety Score: Baseline
52.7 Unit on a scale
Standard Error 1.5
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
State Anxiety Score: Change at Week 4
-6.1 Unit on a scale
Standard Error 1.2
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
Trait Anxiety Score: Change at Week 4
-8.4 Unit on a scale
Standard Error 1.3
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
State Anxiety Score: Change at Week 8
-7.8 Unit on a scale
Standard Error 1.3
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
Trait Anxiety Score: Change at Week 8
-8.4 Unit on a scale
Standard Error 1.3
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
State Anxiety Score: Change at Week 12
-9.4 Unit on a scale
Standard Error 1.3
Change From Baseline in the State-Trait Anxiety Inventory (STAI) Scale
Trait Anxiety Score: Change at Week 12
-10.7 Unit on a scale
Standard Error 1.3

SECONDARY outcome

Timeframe: Screening (Week -2), 4 and 12

Population: ITTe included all participants who received at least 1 dose of study medication and provided at least 1 post-baseline measure of effectiveness.

It is a 21-item clinician-rated scale that evaluates depressed mood as well as the vegetative and cognitive symptoms of depression. 11 items are scored on a 3 point scale (0=none/absent to 2=most severe), 2 items are scored on a 4 point scale (0=none/absent to 3=most severe) and 8 items are scored on a 5 point scale (0=none/absent to 4=most severe). The individual items are summed to yield the HAM-D total score that ranges from 0-60, where higher scores indicate worsening.

Outcome measures

Outcome measures
Measure
Methylphenidate
n=58 Participants
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Change From Screening in the Hamilton Depression Rating (HAM-D) Scale Score at Week 4 and 12
Screening (Week -2)
5.9 Unit on a scale
Standard Error 0.6
Change From Screening in the Hamilton Depression Rating (HAM-D) Scale Score at Week 4 and 12
Change at Week 4
-2.8 Unit on a scale
Standard Error 0.6
Change From Screening in the Hamilton Depression Rating (HAM-D) Scale Score at Week 4 and 12
Change at Week12
-3.3 Unit on a scale
Standard Error 0.6

Adverse Events

Methylphenidate

Serious events: 0 serious events
Other events: 48 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Methylphenidate
n=60 participants at risk
Oral long acting methylphenidate tablets were administered daily at a starting dose of 18 milligram (mg) and slowly increased to 36 mg on Day 8. Depending on response, tolerability and clinician's discretion, the dose could be increased to 54 mg on Day 28 to a maximum of 72 mg per day on Day 56, until each participant achieved optimal dose.
Cardiac disorders
Tachycardia
15.0%
9/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Gastrointestinal disorders
Dry mouth
23.3%
14/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
General disorders
Irritability
13.3%
8/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Infections and infestations
Nasopharyngitis
10.0%
6/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Metabolism and nutrition disorders
Decreased appetite
31.7%
19/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Gastrointestinal disorders
Nausea
6.7%
4/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Nervous system disorders
Headache
30.0%
18/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Nervous system disorders
Somnolence
5.0%
3/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Psychiatric disorders
Affect lability
5.0%
3/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Psychiatric disorders
Anxiety
10.0%
6/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Nervous system disorders
Initial insomnia
10.0%
6/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Nervous system disorders
Insomnia
10.0%
6/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Nervous system disorders
Libido decreased
6.7%
4/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Nervous system disorders
Nervousness
5.0%
3/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.
Nervous system disorders
Sleep disorder
5.0%
3/60 • Baseline up to end of study.
An adverse event may be an undesirable and unintended sign (including an abnormal measurement), symptom or disease which is related to the study drug in terms of time regardless of the existence of a causal relationship with the study drug.

Additional Information

Medical Manager

Janssen-Cilag Farmaceutica Ltda

Phone: +55 11 30302738

Results disclosure agreements

  • Principal investigator is a sponsor employee The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days from the time submitted to the sponsor for review. The sponsor can require changes to the communication and can extend the embargo.
  • Publication restrictions are in place

Restriction type: OTHER