Trial Outcomes & Findings for Efficacy of GXR as Adjunctive Therapy With Psycho-stimulant on Executive Function in Children With ADHD (NCT NCT01985581)

NCT ID: NCT01985581

Last Updated: 2016-05-23

Results Overview

The Behavioural Rating Inventory of Executive Function (BRIEF) was developed to assess such real-world expressions of executive function in the home (BRIEF-P) as assessed by the parent. This is an 86 item questionnaire completed by the parents. The score is converted to a t-score with a score less than 65 being considered within the normal range. Higher scores are worsening in function.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

50 participants

Primary outcome timeframe

measured at baseline and end of each 12 week treament arm

Results posted on

2016-05-23

Participant Flow

Subjects were recruited from principal investigators clinical practice as well as through advertisement in local medical offices and through print and radio advertisements

Participant milestones

Participant milestones
Measure
Placebo First Then GXR
patient will continue to take stable dosage of usual stimulant therapy (Ritalin, Ritalin SR, Biphentin, Concerta, Vyvanse, Adderall or Dexedrine) and placebo for the first intervention period and GXR for the second intervention period (after a washout period). GXR dose was optimized to between 1 and 4mg.
GXR First Then Placebo
patient will continue to take stable dosage of usual stimulant therapy (Ritalin, Ritalin SR, Biphentin, Concerta, Vyvanse, Adderall or Dexedrine) and GXR for the first intervention period and placebo for the second intervention period (after a washout period). GXR dose was optimized to between 1 and 4mg.
First Intervention
STARTED
25
25
First Intervention
COMPLETED
22
23
First Intervention
NOT COMPLETED
3
2
Second Intervention
STARTED
22
23
Second Intervention
COMPLETED
20
19
Second Intervention
NOT COMPLETED
2
4

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Efficacy of GXR as Adjunctive Therapy With Psycho-stimulant on Executive Function in Children With ADHD

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
PLB First Then GXR
n=25 Participants
subjects received PLB in first arm of study and GXR in second arm. subject continued to take stable dosage of usual stimulant therapy (Ritalin, Ritalin SR, Biphentin, Concerta, Vyvanse, Adderall or Dexedrine)
GXR First Then PLB
n=25 Participants
subjects received GXR in first arm of study and PLB in second arm subject continued to take stable dosage of usual stimulant therapy (Ritalin, Ritalin SR, Biphentin, Concerta, Vyvanse, Adderall or Dexedrine)
Total
n=50 Participants
Total of all reporting groups
Age, Continuous
9.0 years
n=5 Participants
10 years
n=7 Participants
9.5 years
n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
3 Participants
n=7 Participants
8 Participants
n=5 Participants
Sex: Female, Male
Male
20 Participants
n=5 Participants
22 Participants
n=7 Participants
42 Participants
n=5 Participants
Region of Enrollment
Canada
25 participants
n=5 Participants
25 participants
n=7 Participants
50 participants
n=5 Participants

PRIMARY outcome

Timeframe: measured at baseline and end of each 12 week treament arm

Population: ITT population - consisting of subjects who took at least one dose of treatment and completed at least one non-baseline BRIEF questionnaire during either period 1 or period 2.

The Behavioural Rating Inventory of Executive Function (BRIEF) was developed to assess such real-world expressions of executive function in the home (BRIEF-P) as assessed by the parent. This is an 86 item questionnaire completed by the parents. The score is converted to a t-score with a score less than 65 being considered within the normal range. Higher scores are worsening in function.

Outcome measures

Outcome measures
Measure
Placebo and Stimulant
n=48 Participants
Subjects received placebo and usual stimulant therapy
GXR and Stimulant
n=47 Participants
Subjects received GXR (1-4 mg as optimized dosage) in addition to usual stimulant therapy
Effect of Adjunctive INTUNIV Extended Release Treatment on Executive Function as Assessed by Change From Baseline on the BRIEF-parent Questionnaires
-5.3 units on a scale
Standard Error 1.46
-6.9 units on a scale
Standard Error 1.53

SECONDARY outcome

Timeframe: Measured at baseline and end of each 12 week treatment arm

Population: ITT population - consisting of subjects who took at least one dose of treatment and completed at least one non-baseline questionnaire during either period 1 or period 2.

The KINDL is a quality of life questionnaire of 24 items completed by the subject (KINDL-child). It is a generic instrument for assessing Health Related quality of life in children and adolescents aged 3 years and older. Norm values are given based on representative German data from the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, a broad survey realized by the German Robert-Koch Institute. The KINDL scores were converted to range between 0 and 100 with higher scores indicating better quality of life as reported by the child

Outcome measures

Outcome measures
Measure
Placebo and Stimulant
n=47 Participants
Subjects received placebo and usual stimulant therapy
GXR and Stimulant
n=46 Participants
Subjects received GXR (1-4 mg as optimized dosage) in addition to usual stimulant therapy
Effect of Adjunctive INTUNIV Extended Release Treatment on Change in Quality of Life as Assessed by the KINDL®-Child Questionnaire.
0.8 units on a scale
Standard Error 1.58
1.2 units on a scale
Standard Error 1.62

SECONDARY outcome

Timeframe: comparison from baseline to end of each 12 week treatment arm

Population: ITT population - consisting of subjects who took at least one dose of treatment and completed at least one non-baseline questionnaire during either period 1 or period 2.

The ADHD-RS-IV is completed by the Investigator familiar with the scale. It is an 18 item scale designed to reflect current symptomatology of ADHD based on the DSM-5 criteria. Each item is scored from a range of 0 (reflecting no symptoms) to 3 (reflecting severe symptoms) with total scores ranging from 0-54, with higher scores reflecting more severe symptoms

Outcome measures

Outcome measures
Measure
Placebo and Stimulant
n=48 Participants
Subjects received placebo and usual stimulant therapy
GXR and Stimulant
n=47 Participants
Subjects received GXR (1-4 mg as optimized dosage) in addition to usual stimulant therapy
Effect of Adjunct Therapy on ADHD Symptom Control as Assessed by the Change in the ADHD Rating Scale (ADHD-RS-IV)
-5.5 units on a scale
Standard Error 1.63
-11.1 units on a scale
Standard Error 1.51

SECONDARY outcome

Timeframe: Measured up to 30 weeks

Population: ITT population - consisting of subjects who took at least one dose of treatment and completed at least one non-baseline questionnaire during either period 1 or period 2.

To compare the number of subjects experiencing suicidal ideation, suicidal behaviour and self-injurious behaviour without suicidal intent as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS) and incident of Serious Adverse Events (SAEs) in each treatment arm

Outcome measures

Outcome measures
Measure
Placebo and Stimulant
n=50 Participants
Subjects received placebo and usual stimulant therapy
GXR and Stimulant
n=50 Participants
Subjects received GXR (1-4 mg as optimized dosage) in addition to usual stimulant therapy
Subjects Experiencing Suicidal Ideation, Suicidal Behaviour and Self-injurious Behaviour Without Suicidal Intent and Incident of Serious Adverse Events in Each Treatment Arm
1 subjects
1 subjects

SECONDARY outcome

Timeframe: Measured at baseline and end of each 12 week treatment arm

Population: ITT population - consisting of subjects who took at least one dose of treatment and completed at least one non-baseline questionnaire during either period 1 or period 2.

The KINDL is a quality of life questionnaire of 24 items completed by the parent (KINDL-parent). It is a generic instrument for assessing Health Related quality of life in children and adolescents aged 3 years and older. Norm values are given based on representative German data from the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, a broad survey realized by the German Robert-Koch Institute. The KINDL scores were converted to range between 0 and 100 with higher scores indicating better quality of life as reported by the parent.

Outcome measures

Outcome measures
Measure
Placebo and Stimulant
n=48 Participants
Subjects received placebo and usual stimulant therapy
GXR and Stimulant
n=47 Participants
Subjects received GXR (1-4 mg as optimized dosage) in addition to usual stimulant therapy
Evaluate the Effect of Adjunctive INTUNIV Extended Release Treatment on Change in Quality of Life as Assessed by the KINDL®-Parent Questionnaire.
3.4 units on a scale
Standard Error 1.46
1.4 units on a scale
Standard Error 1.45

SECONDARY outcome

Timeframe: comparison from baseline to end of each 12 week treatment arm

Population: ITT population - consisting of subjects who took at least one dose of treatment and completed at least one non-baseline questionnaire during either period 1 or period 2.

The Clinical Global Impression- Severity scale is a scale of illness ranging from 1 (normal) to 7 (among the most severely ill patients). Subjects who felt normal, not at all ill or borderline mentally ill are considered improved. The outcome measure is reporting the percentage of participants showing improvement

Outcome measures

Outcome measures
Measure
Placebo and Stimulant
n=48 Participants
Subjects received placebo and usual stimulant therapy
GXR and Stimulant
n=47 Participants
Subjects received GXR (1-4 mg as optimized dosage) in addition to usual stimulant therapy
Effect of Adjunct Therapy on ADHD Symptom Control as Assessed by the Change on the Clinical Global Impression of Severity (CGI-S) Scale
10.6 percentage of subjects
29.8 percentage of subjects

SECONDARY outcome

Timeframe: comparison from baseline to end of each 12 week treatment arm

Population: ITT population - consisting of subjects who took at least one dose of treatment and completed at least one non-baseline questionnaire during either period 1 or period 2.

CGI-I is a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Subjects who felt very much improved or much improved are considered improved.The outcome measure is reporting the percentage of participants showing improvement

Outcome measures

Outcome measures
Measure
Placebo and Stimulant
n=48 Participants
Subjects received placebo and usual stimulant therapy
GXR and Stimulant
n=47 Participants
Subjects received GXR (1-4 mg as optimized dosage) in addition to usual stimulant therapy
Evaluate the Effect of Adjunct Therapy on ADHD Symptom Control as Assessed by the Change in Clinical Global Impression of Improvement (CGI-I) Scale
27.7 percentage of subjects
57.4 percentage of subjects

Adverse Events

Stimulant and GXR

Serious events: 0 serious events
Other events: 41 other events
Deaths: 0 deaths

Stimulant and PLB

Serious events: 0 serious events
Other events: 41 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Stimulant and GXR
n=47 participants at risk
adverse event frequency in those taking stimulant + GXR
Stimulant and PLB
n=48 participants at risk
adverse event frequency in those taking stimulant + PLB
Nervous system disorders
Headache
48.9%
23/47 • from time consent was signed until end of study (week 30)
33.3%
16/48 • from time consent was signed until end of study (week 30)
Respiratory, thoracic and mediastinal disorders
Upper Respiratory Tract Infection
25.5%
12/47 • from time consent was signed until end of study (week 30)
37.5%
18/48 • from time consent was signed until end of study (week 30)
Gastrointestinal disorders
Abdominal Upper Pain
29.8%
14/47 • from time consent was signed until end of study (week 30)
10.4%
5/48 • from time consent was signed until end of study (week 30)
Nervous system disorders
Insomnia
10.6%
5/47 • from time consent was signed until end of study (week 30)
18.8%
9/48 • from time consent was signed until end of study (week 30)
Gastrointestinal disorders
Vomiting
10.6%
5/47 • from time consent was signed until end of study (week 30)
16.7%
8/48 • from time consent was signed until end of study (week 30)
Nervous system disorders
Fatigue
23.4%
11/47 • from time consent was signed until end of study (week 30)
2.1%
1/48 • from time consent was signed until end of study (week 30)
Gastrointestinal disorders
Gastroenteritis
12.8%
6/47 • from time consent was signed until end of study (week 30)
10.4%
5/48 • from time consent was signed until end of study (week 30)
Psychiatric disorders
Affect Lability
12.8%
6/47 • from time consent was signed until end of study (week 30)
2.1%
1/48 • from time consent was signed until end of study (week 30)
Nervous system disorders
Somnolence
10.6%
5/47 • from time consent was signed until end of study (week 30)
4.2%
2/48 • from time consent was signed until end of study (week 30)
General disorders
Pyrexia
6.4%
3/47 • from time consent was signed until end of study (week 30)
6.2%
3/48 • from time consent was signed until end of study (week 30)
Gastrointestinal disorders
Nauseau
2.1%
1/47 • from time consent was signed until end of study (week 30)
8.3%
4/48 • from time consent was signed until end of study (week 30)
General disorders
Sleep disorder
6.4%
3/47 • from time consent was signed until end of study (week 30)
2.1%
1/48 • from time consent was signed until end of study (week 30)

Additional Information

Dr. Judy van Stralen

Center for Pediatric Excellence

Phone: 613-726-7355

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place