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Safety and Effectiveness of D-Cycloserine in Children With Autism

Primary Purpose

Autistic Disorder

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
D-cycloserine
Placebo
Sponsored by
Indiana University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Autistic Disorder focused on measuring Autistic Disorder, cycloserine, pharmacology, glutamatergic agents, communication, social interaction, Double-Blind Method

Eligibility Criteria

3 Years - 12 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Age 3 Years to 12 Years Diagnostic Statistical Manual Version -IV (DSM-IV) and Autism Diagnostic Interview - Revised (ADI-R)-confirmed Diagnosis of Autistic Disorder Aberrant Behavior Checklist (ABC) Lethargy Subscale Score of 13 or greater Exclusion Criteria: Children with Severe to Profound Mental Retardation Weight at Screening Visit <11 kilograms Clinical Global Impressions-Severity Score of 7 Presence of a Neurodevelopmental Disorder with Possible Associations to Autism: Subjects with Fragile X Syndrome, Tuberous Sclerosis, or other neurodevelopmental disorders known to be associated with autism or autistic features will be excluded. Presence of a Psychiatric Disorder that would Require a Specific Type of Treatment: Subjects with major depressive disorder, bipolar disorder, or a psychotic disorder will be excluded because treatment for these disorders often requires specific psychotropic agents. Subjects with an active substance use disorder will be excluded because of safety concerns and problems this would cause in assessing efficacy. Presence of a Medical Condition that would make Treatment with D-Cycloserine Less Safe: Subjects with significant cardiac, hepatic, or renal disease will be excluded due to concerns about pharmacokinetic alterations or adverse effects. Subjects with epilepsy or a history of seizures will be excluded due to rare reports of seizures with high doses of D-cycloserine. D-cycloserine is an U.S. FDA Pregnancy Category C drug. Because of the unknown effects of D-cycloserine on the developing human fetus, females of childbearing potential will be given a urine pregnancy test and required to use a suitable form of birth control during the study.

Sites / Locations

  • Riley Hospital for Children, Christian Sarkine Autism Treatment Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

1

2

Arm Description

Participants will receive D-Cycloserine for 8 weeks.

Participants will receive placebo for 8 weeks.

Outcomes

Primary Outcome Measures

Change in Clinical Global Impressions (CGI) Global Improvement
All randomized subjects in the Double-Blind Phase will be assessed for change.
Change in Clinical Global Impressions (CGI) Global Improvement
All placebo non-responders will enter into an open-label phase after the Double-Blind Phase
Change in Lethargy Subscale of the Aberrant Behavior Checklist (ABC)
All randomized subjects in the Double-Blind Phase will be assessed for change.
Change in Lethargy Subscale of the Aberrant Behavior Checklist (ABC)
All placebo non-responders will enter into an open-label phase after the Double-Blind Phase

Secondary Outcome Measures

Full Information

First Posted
September 12, 2005
Last Updated
April 8, 2016
Sponsor
Indiana University
Collaborators
National Institute of Mental Health (NIMH), National Alliance for Research on Schizophrenia and Depression, Indiana University School of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT00198120
Brief Title
Safety and Effectiveness of D-Cycloserine in Children With Autism
Official Title
A Randomized Controlled Trial of D-Cycloserine in Autism
Study Type
Interventional

2. Study Status

Record Verification Date
April 2016
Overall Recruitment Status
Completed
Study Start Date
February 2004 (undefined)
Primary Completion Date
September 2007 (Actual)
Study Completion Date
August 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Indiana University
Collaborators
National Institute of Mental Health (NIMH), National Alliance for Research on Schizophrenia and Depression, Indiana University School of Medicine

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will determine the effectiveness of D-cycloserine in reducing symptoms of autism in autistic children.
Detailed Description
This project proposes to study the efficacy and safety of D-cycloserine in children with autism. The central hypothesis of this project is that D-cycloserine will be efficacious in reducing certain symptoms of autism including some aspects of social impairment. Autism is a severe neuropsychiatric disorder with a prevalence of at least 0.1 %. Despite investigations into the pharmacologic treatment of autism, no drugs have been shown to consistently improve the core symptoms of the disorder, namely social and communication impairment. Pilot data has suggested that D-cycloserine, a drug that affects the N-methyl-D-aspartate (NMDA) subtype of glutamate receptor, has efficacy for the symptom of social withdrawal in autism. In this study, children with autism will be randomly assigned to treatment with either D-cycloserine or placebo for 8 weeks. Both the subjects and investigators will be blind to treatment assignment. Subjects will be rated on a variety of clinical measures to examine the effects of D-cycloserine on social withdrawal and other symptoms of autism. Safety data including side-effects, vital signs, blood tests, and electrocardiograms will be performed at the beginning and end of the study. This study will provide important information about the effects of D-cycloserine for treating core and associated symptoms of autism. It will also greatly expand the knowledge about glutamatergic agents in autism and provide crucial information regarding the pathophysiology and future design of drug studies in autism.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autistic Disorder
Keywords
Autistic Disorder, cycloserine, pharmacology, glutamatergic agents, communication, social interaction, Double-Blind Method

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
80 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Participants will receive D-Cycloserine for 8 weeks.
Arm Title
2
Arm Type
Placebo Comparator
Arm Description
Participants will receive placebo for 8 weeks.
Intervention Type
Drug
Intervention Name(s)
D-cycloserine
Other Intervention Name(s)
Seromycin, Cycloserine
Intervention Description
D-Cycloserine 0.6mg/kg/day in week 1 D-Cycloserine 1.1mg/kg/day in week 2 D-Cycloserine 1.7mg/kg/day in week 3-8 Flexible dosing based on response. Capsule Strength: 10mg, 20mg
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo: same dosing schedule and capsule strength
Primary Outcome Measure Information:
Title
Change in Clinical Global Impressions (CGI) Global Improvement
Description
All randomized subjects in the Double-Blind Phase will be assessed for change.
Time Frame
Change from Baseline at 8 Weeks
Title
Change in Clinical Global Impressions (CGI) Global Improvement
Description
All placebo non-responders will enter into an open-label phase after the Double-Blind Phase
Time Frame
Change from Open-Label Baseline at 8 Weeks
Title
Change in Lethargy Subscale of the Aberrant Behavior Checklist (ABC)
Description
All randomized subjects in the Double-Blind Phase will be assessed for change.
Time Frame
Change from Baseline at 8 Weeks.
Title
Change in Lethargy Subscale of the Aberrant Behavior Checklist (ABC)
Description
All placebo non-responders will enter into an open-label phase after the Double-Blind Phase
Time Frame
Change from Open-Label Baseline at 8 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 3 Years to 12 Years Diagnostic Statistical Manual Version -IV (DSM-IV) and Autism Diagnostic Interview - Revised (ADI-R)-confirmed Diagnosis of Autistic Disorder Aberrant Behavior Checklist (ABC) Lethargy Subscale Score of 13 or greater Exclusion Criteria: Children with Severe to Profound Mental Retardation Weight at Screening Visit <11 kilograms Clinical Global Impressions-Severity Score of 7 Presence of a Neurodevelopmental Disorder with Possible Associations to Autism: Subjects with Fragile X Syndrome, Tuberous Sclerosis, or other neurodevelopmental disorders known to be associated with autism or autistic features will be excluded. Presence of a Psychiatric Disorder that would Require a Specific Type of Treatment: Subjects with major depressive disorder, bipolar disorder, or a psychotic disorder will be excluded because treatment for these disorders often requires specific psychotropic agents. Subjects with an active substance use disorder will be excluded because of safety concerns and problems this would cause in assessing efficacy. Presence of a Medical Condition that would make Treatment with D-Cycloserine Less Safe: Subjects with significant cardiac, hepatic, or renal disease will be excluded due to concerns about pharmacokinetic alterations or adverse effects. Subjects with epilepsy or a history of seizures will be excluded due to rare reports of seizures with high doses of D-cycloserine. D-cycloserine is an U.S. FDA Pregnancy Category C drug. Because of the unknown effects of D-cycloserine on the developing human fetus, females of childbearing potential will be given a urine pregnancy test and required to use a suitable form of birth control during the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christopher J. McDougle, MD
Organizational Affiliation
Indiana University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Riley Hospital for Children, Christian Sarkine Autism Treatment Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
33583058
Citation
Aye SZ, Ni H, Sein HH, Mon ST, Zheng Q, Wong YKY. The effectiveness and adverse effects of D-cycloserine compared with placebo on social and communication skills in individuals with autism spectrum disorder. Cochrane Database Syst Rev. 2021 Feb 14;2(2):CD013457. doi: 10.1002/14651858.CD013457.pub2.
Results Reference
derived

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Safety and Effectiveness of D-Cycloserine in Children With Autism

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