Trial Outcomes & Findings for Atomoxetine PBPK-PD Clinical Study (NCT NCT03154359)

NCT ID: NCT03154359

Last Updated: 2023-08-08

Results Overview

Classification of participants as "responders" versus "non-responders" is based on percent reduction in total National Initiative for Children's Healthcare Quality (NICHQ) Vanderbilt Assessment Scale (3rd edition) score from baseline. Participants with ≥40% reduction in total score from baseline are classified as responders. The scale assesses the presence and severity of 18 DSM-V criteria for attention deficit hyperactivity disorder (ADHD) symptoms. Symptoms are rated on a 4-point Likert-type scale: 0 ("Never") to 3 ("Very Often"). Maximum total symptom score is 54.The measure includes 8 questions assessing functional impairment ("Performance"). Impairment is rated on a 5-point Likert-type scale: 1 ("Excellent") to 5 ("Problematic").

Recruitment status

COMPLETED

Target enrollment

51 participants

Primary outcome timeframe

6 weeks

Results posted on

2023-08-08

Participant Flow

Participants were recruited over 6 years from a patient population seeking care for Attention Deficit Hyperactivity Disorder (ADHD).

A total of 51 participants were enrolled in the study. All participants completed a screening visit, and 9 participants screenfailed/were determined to be ineligible.

Participant milestones

Participant milestones
Measure
Atomoxetine HCl (Strattera)
Study participants will receive atomoxetine at a dose expected to result in steady-state maximum concentration (Cmax,ss) values of 400 ng/mL. Dose will be calculated using a model based on CYP2D6 predicted phenotype, height, weight, body habitus, and gender. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Overall Study
STARTED
42
Overall Study
6 Weeks
29
Overall Study
18 Weeks
20
Overall Study
COMPLETED
20
Overall Study
NOT COMPLETED
22

Reasons for withdrawal

Reasons for withdrawal
Measure
Atomoxetine HCl (Strattera)
Study participants will receive atomoxetine at a dose expected to result in steady-state maximum concentration (Cmax,ss) values of 400 ng/mL. Dose will be calculated using a model based on CYP2D6 predicted phenotype, height, weight, body habitus, and gender. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Overall Study
Adverse Event
1
Overall Study
Lack of Efficacy
2
Overall Study
Lost to Follow-up
3
Overall Study
Physician Decision
3
Overall Study
Protocol Violation
4
Overall Study
Withdrawal by Subject
5
Overall Study
Disruption of study due to COVID-19
4

Baseline Characteristics

Atomoxetine PBPK-PD Clinical Study

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Atomoxetine HCl (Strattera)
n=42 Participants
Study participants will receive atomoxetine at a dose expected to result in steady-state maximum concentration (Cmax,ss) values of 400 ng/mL. Individualized dose to achieve the desired Cmax,ss of 400 ng/ml (approximately 90 minutes after dose administration) is determined using a pharmacokinetic model that includes as input information each participant's CYP2D6 genotype-predicted phenotype, height, weight, body habitus, and gender. Study clinicians may titrate up the dose to reach predicted Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Age, Continuous
10.62 years
STANDARD_DEVIATION 2.75 • n=5 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
Sex: Female, Male
Male
36 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
40 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
14 Participants
n=5 Participants
Race (NIH/OMB)
White
22 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
6 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Neuropsychiatric Comorbidities
Anxiety
3 Participants
n=5 Participants
Neuropsychiatric Comorbidities
Oppositional Defiant Disorder
4 Participants
n=5 Participants
Neuropsychiatric Comorbidities
Dyslexia
2 Participants
n=5 Participants
Neuropsychiatric Comorbidities
Learning Delay
2 Participants
n=5 Participants
Neuropsychiatric Comorbidities
Other
2 Participants
n=5 Participants
Neuropsychiatric Comorbidities
None
29 Participants
n=5 Participants
Weight
42.93 kilograms (kg)
STANDARD_DEVIATION 20.78 • n=5 Participants
ADHD Subtype (based on NICHQ Vanderbilt Assessment Scale score)
Inattentive Subtype
9 Participants
n=5 Participants
ADHD Subtype (based on NICHQ Vanderbilt Assessment Scale score)
Hyperactive/Impulsive Subtype
2 Participants
n=5 Participants
ADHD Subtype (based on NICHQ Vanderbilt Assessment Scale score)
Combined Subtype
27 Participants
n=5 Participants
ADHD Subtype (based on NICHQ Vanderbilt Assessment Scale score)
Below Threshold
4 Participants
n=5 Participants
ADHD Subtype (based on K-SADS-PL)
Inattentive Subtype
16 Participants
n=5 Participants
ADHD Subtype (based on K-SADS-PL)
Hyperactive/Impulsive Subtype
3 Participants
n=5 Participants
ADHD Subtype (based on K-SADS-PL)
Combine Subtype
21 Participants
n=5 Participants
ADHD Subtype (based on K-SADS-PL)
Below Threshold
2 Participants
n=5 Participants
CYP2D6 Activity Score
0
3 Participants
n=5 Participants
CYP2D6 Activity Score
0.25
3 Participants
n=5 Participants
CYP2D6 Activity Score
0.5
1 Participants
n=5 Participants
CYP2D6 Activity Score
0.75
1 Participants
n=5 Participants
CYP2D6 Activity Score
1
15 Participants
n=5 Participants
CYP2D6 Activity Score
1.25
6 Participants
n=5 Participants
CYP2D6 Activity Score
1.5
5 Participants
n=5 Participants
CYP2D6 Activity Score
2
7 Participants
n=5 Participants
CYP2D6 Activity Score
3
1 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 6 weeks

Population: Individuals who completed 6 week milestone

Classification of participants as "responders" versus "non-responders" is based on percent reduction in total National Initiative for Children's Healthcare Quality (NICHQ) Vanderbilt Assessment Scale (3rd edition) score from baseline. Participants with ≥40% reduction in total score from baseline are classified as responders. The scale assesses the presence and severity of 18 DSM-V criteria for attention deficit hyperactivity disorder (ADHD) symptoms. Symptoms are rated on a 4-point Likert-type scale: 0 ("Never") to 3 ("Very Often"). Maximum total symptom score is 54.The measure includes 8 questions assessing functional impairment ("Performance"). Impairment is rated on a 5-point Likert-type scale: 1 ("Excellent") to 5 ("Problematic").

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Number of Participants Classified as Responders and Non-responders to Intervention
Responders
14 Participants
Number of Participants Classified as Responders and Non-responders to Intervention
Non-Responders
15 Participants

PRIMARY outcome

Timeframe: 18 weeks

Population: Participants who completed 18 week milestone

Classification of participants as "responders" versus "non-responders" is based on percent reduction in total National Initiative for Children's Healthcare Quality (NICHQ) Vanderbilt Assessment Scale (3rd edition) score from baseline. Participants with ≥40% reduction in total score from baseline are classified as responders. The scale assesses the presence and severity of 18 DSM-V criteria for attention deficit hyperactivity disorder (ADHD) symptoms. Symptoms are rated on a 4-point Likert-type scale: 0 ("Never") to 3 ("Very Often"). Maximum total symptom score is 54.The measure includes 8 questions assessing functional impairment ("Performance"). Impairment is rated on a 5-point Likert-type scale: 1 ("Excellent") to 5 ("Problematic").

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=20 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Number of Participants Classified as Responders and Non-responders to Intervention
Responder
13 Participants
Number of Participants Classified as Responders and Non-responders to Intervention
Non-Responder
7 Participants

PRIMARY outcome

Timeframe: Baseline (first dose)

Population: 6-week and 18-week responder classifications have different sample sizes, as there are 2 milestones within this study.

Cmax is the highest concentration of atomoxetine measured over a 12-hour period following administration of the drug on pharmacokinetic study days occurring at baseline (first dose). Cmax is an estimate of atomoxetine systemic exposure and is compared between responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Maximum Plasma Concentration (Cmax) of Atomoxetine
Responder at 6 weeks
268.5 ng/mL
Standard Deviation 117.2
Maximum Plasma Concentration (Cmax) of Atomoxetine
Non-Responder at 6 weeks
220.4 ng/mL
Standard Deviation 76.0
Maximum Plasma Concentration (Cmax) of Atomoxetine
Responder at 18 weeks
247.8 ng/mL
Standard Deviation 128.7
Maximum Plasma Concentration (Cmax) of Atomoxetine
Non-Responder at 18 weeks
216.2 ng/mL
Standard Deviation 77.3

PRIMARY outcome

Timeframe: 6 weeks

Population: Participants who completed 6 week milestone

Cmax is the highest concentration of atomoxetine measured following administration of the drug on pharmacokinetic study days occurring at 6 weeks. Cmax is an estimate of atomoxetine systemic exposure and is compared between responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Maximum Plasma Concentration (Cmax) of Atomoxetine
Responders
554.2 ng/mL
Standard Error 63.5
Maximum Plasma Concentration (Cmax) of Atomoxetine
Non-Responders
501.7 ng/mL
Standard Error 61.4

PRIMARY outcome

Timeframe: 18 weeks

Population: The overall participants were classified into 2 groups based on responder status.

Cmax is the highest concentration of atomoxetine measured following administration of the drug on pharmacokinetic study days occurring at 18 weeks. Cmax is an estimate of atomoxetine systemic exposure and is compared between responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=20 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Maximum Plasma Concentration (Cmax) of Atomoxetine
Responders
601.3 ng/mL
Standard Error 88.2
Maximum Plasma Concentration (Cmax) of Atomoxetine
Non-Responders
375.5 ng/mL
Standard Error 120.2

PRIMARY outcome

Timeframe: Baseline (first dose)

Population: 6-week and 18-week responder classifications have different sample sizes, as there are 2 milestones within this study.

AUC is the area under the plasma concentration-time curve following administration of atomoxetine. For the baseline pharmacokinetic study (first dose of atomoxetine) plasma concentrations were measured at 17 timepoints between 0 and 72 hours (0, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24, 48, and 72 hours) post-dose for CYP2D6 poor and intermediate metabolizers, and 12 timepoints between 0 and 12 hours (0, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, and 12 hours) after dose administration for all other participants. The AUC was generated using a mixed log-linear approach and extrapolated to infinity. AUC is compared between responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Responder at 6 weeks
1515.3 (ng*hours)/mL
Standard Deviation 1169.2
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Non-responder at 6 weeks
1246.9 (ng*hours)/mL
Standard Deviation 913.4
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Responder at 18 weeks
1495.7 (ng*hours)/mL
Standard Deviation 1197.6
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Non-responder at 18 weeks
1462.7 (ng*hours)/mL
Standard Deviation 1283.4

PRIMARY outcome

Timeframe: 6 weeks

Population: The overall participants were classified into 2 groups based on responder status.

For the steady-state pharmacokinetic studies at 6 weeks, plasma concentrations were measured at 15 timepoints between 0 and 24 hours (0, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 hours) post-dose for CYP2D6 poor and intermediate metabolizers, and at 12 timepoints between 0 and 12 hours (0, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, and 12 hours) and extrapolated to 24 hours for all other participants. AUC is compared between responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Responders
2802.5 (ng*hours)/mL
Standard Error 423.4
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Non-Responders
2809.4 (ng*hours)/mL
Standard Error 409.0

PRIMARY outcome

Timeframe: 18 weeks

Population: The overall participants were classified into 2 groups based on responder status.

For the steady-state pharmacokinetic studies at 18 weeks, plasma concentrations were measured at 15 timepoints between 0 and 24 hours (0, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 hours) post-dose for CYP2D6 poor and intermediate metabolizers, and at 12 timepoints between 0 and 12 hours (0, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, and 12 hours) and extrapolated to 24 hours for all other participants. AUC is compared between responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=20 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Responders
3149.2 (ng*hours)/mL
Standard Error 511.3
Area Under the Plasma Concentration-time Curve (AUC) of Atomoxetine
Non-Responders
2880.0 (ng*hours)/mL
Standard Error 696.7

PRIMARY outcome

Timeframe: Baseline

Population: 6-week and 18-week responder classifications have different sample sizes, as there are 2 milestones within this study.

DHPG has been proposed as a biomarker of the activity of the norepinephrine reuptake transporter (NET; SLC6A2), the target of atomoxetine action. DHPG is a degradation product of norepinephrine after it has been taken up by pre-synaptic neurons, and higher concentrations in plasma are considered to reflect higher NET activity (higher reuptake of norepinephrine into pre-synaptic neurons). To assess the potential value of DHPG as a biomarker of atomoxetine response in ADHD, absolute baseline and pre-dose concentrations of DHPG will be compared between atomoxetine responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Responder at 6 weeks
0.363 ng/mL
Standard Deviation 0.164
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Non-responder at 6 weeks
0.412 ng/mL
Standard Deviation 0.178
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Responder at 18 weeks
0.382 ng/mL
Standard Deviation 0.177
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Non-responder at 18 weeks
0.363 ng/mL
Standard Deviation 0.184

PRIMARY outcome

Timeframe: 6 weeks

Population: The overall participants were classified into 2 groups based on responder status.

DHPG has been proposed as a biomarker of the activity of the norepinephrine reuptake transporter (NET; SLC6A2), the target of atomoxetine action. DHPG is a degradation product of norepinephrine after it has been taken up by pre-synaptic neurons, and higher concentrations in plasma are considered to reflect higher NET activity (higher reuptake of norepinephrine into pre-synaptic neurons). To assess the potential value of DHPG as a biomarker of atomoxetine response in ADHD, pre-dose concentration of DHPG at the 6-week pharmacokinetic study visit will be compared between atomoxetine responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Responders
0.395 ng/mL
Standard Deviation 0.150
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Non-Responders
0.345 ng/mL
Standard Deviation 0.125

PRIMARY outcome

Timeframe: 18 weeks

Population: The overall participants were classified into 2 groups based on responder status.

DHPG has been proposed as a biomarker of the activity of the norepinephrine reuptake transporter (NET; SLC6A2), the target of atomoxetine action. DHPG is a degradation product of norepinephrine after it has been taken up by pre-synaptic neurons, and higher concentrations in plasma are considered to reflect higher NET activity (higher reuptake of norepinephrine into pre-synaptic neurons). To assess the potential value of DHPG as a biomarker of atomoxetine response in ADHD, pre-dose concentration of DHPG at the 18-week pharmacokinetic study visit will be compared between atomoxetine responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=20 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Responders
0.323 ng/mL
Standard Deviation 0.140
Plasma Concentration of 3,4-dihydroxyphenylglycol (DHPG)
Non-responders
0.283 ng/mL
Standard Deviation 0.139

PRIMARY outcome

Timeframe: 6 weeks

Population: The overall participants were classified into 2 groups based on responder status.

The change in DHPG will be compared between atomoxetine responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=29 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Change in Plasma Concentration of DHPG From Baseline
Responders
0.031 ng/mL
Standard Deviation 0.180
Change in Plasma Concentration of DHPG From Baseline
Non-Responders
-0.066 ng/mL
Standard Deviation 0.157

PRIMARY outcome

Timeframe: 18 weeks

Population: The overall participants were classified into 2 groups based on responder status.

The change in DHPG will be compared between atomoxetine responders and non-responders.

Outcome measures

Outcome measures
Measure
Atomoxetine HCl (Strattera)
n=20 Participants
Study participants will receive atomoxetine at a dose expected to result in Cmax,ss values of 400 ng/mL. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Change in Plasma Concentration of DHPG From Baseline
Responders
-0.059 ng/mL
Standard Deviation 0.074
Change in Plasma Concentration of DHPG From Baseline
Non-responders
-0.081 ng/mL
Standard Deviation 0.140

Adverse Events

Atomoxetine HCl (Strattera)

Serious events: 0 serious events
Other events: 37 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Atomoxetine HCl (Strattera)
n=42 participants at risk
Study participants will receive atomoxetine at a dose expected to result in steady-state maximum concentration (Cmax,ss) values of 400 ng/mL. Dose will be calculated using a model based on CYP2D6 predicted phenotype, height, weight, body habitus, and gender. Study clinicians may titrate up the dose to reach Cmax,ss values of 600 ng/mL or 800 ng/mL according to participant response.
Gastrointestinal disorders
Nausea/Vomiting/Upset Stomach
47.6%
20/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Gastrointestinal disorders
Decreased Appetite
9.5%
4/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Gastrointestinal disorders
Diarrhea
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Infections and infestations
Cold/Flu
23.8%
10/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Infections and infestations
Fever
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Infections and infestations
Ear Infection
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Infections and infestations
Sore Throat
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Nervous system disorders
Headache
21.4%
9/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Psychiatric disorders
Irritability
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Psychiatric disorders
Mood Disturbance
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Psychiatric disorders
Self-Injurious Behavior
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
General disorders
Fatigue
19.0%
8/42 • Adverse event data was collected over the full 18 weeks of participation in the study.
Musculoskeletal and connective tissue disorders
Foot injury
4.8%
2/42 • Adverse event data was collected over the full 18 weeks of participation in the study.

Additional Information

James Steven Leeder, PharmD, PhD

Children's Mercy Hospital

Phone: 816-731-7116

Results disclosure agreements

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