International Study to Predict Optimised Treatment in Attention Deficit/Hyperactivity Disorder
Primary Purpose
Attention Deficit/Hyperactivity Disorder
Status
Unknown status
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Short Acting Methylphenidate
Long Acting Methylphenidate
Sponsored by
About this trial
This is an interventional health services research trial for Attention Deficit/Hyperactivity Disorder focused on measuring Attention Deficit/Hyperactivity Disorder, Attention Deficit Disorder, ADHD, ADD, iSPOT
Eligibility Criteria
Inclusion Criteria:
- Subjects who have signed an informed consent or assent form where required and/or whose parent or legal guardian has provided written informed consent.
- Subjects who meet DSM-IV criteria for primary diagnosis of ADHD at study entry, as determined by a psychiatrist, physician or clinical psychologist in conjunction with the clinical work-up undertaken by trained research assistants, as defined by The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid).
- Subjects who score at least 6 Inattentive or Hyperactive/impulsive items >1 on the Attention Deficit / Hyperactivity Disorder Rating Scale.
- Subjects who are stimulant naïve or stimulant free (defined as no stimulant medication in the previous 7 days*).
- Subjects who are 6-17 years of age (with an emphasis to enrol at least a third of the subjects who are ≥ 13 years of age).
Subjects who are fluent and literate in English (and/or Dutch in The Netherlands).
- coming off the stimulant medication for 7 days may place the participant at increased risk, therefore, the participant may have this washout period reduced to that defined in the drug package insert or 5 times the medication half life.
Exclusion Criteria:
- Known contra-indication or intolerance to the use of methylphenidate as defined in the product package insert (including previous treatment failure at the highest recommended dose).
- Pregnancy and females of child bearing potential who are not using a form of contraception and are at risk of becoming pregnant during the study.
- Known medical condition, disease or neurological disorder which might, in the opinion of investigator/s, interfere with the assessments to be made in the study or put ADHD patients at increased risk when exposed to optimal doses of the drug treatment. For example, a diagnosis of epilepsy would exclude a patient from this trial.
- History of physical brain injury or blow to the head that resulted in loss of consciousness for at least 10 minutes or at least 5minutes within the last two years. Prior treatment with methylphenidate or any other stimulant medication in the past 7 days.
- Known past or present substance dependence, including alcohol, as determined by The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid).
- Participation in an investigational study within four months of the baseline visit in which subjects have received an experimental drug/device that could affect the primary end points of this study.
- Use of any psychological or counselling therapy or CNS medication that cannot be washed out prior to participation or use of any psychological or counselling therapy between the baseline and week 6 (or Early Termination) visits.
- Subjects who, in the opinion of the investigator, have a severe impediment to vision, hearing and/or hand movement, which is likely to interfere with their ability to complete the testing batteries.
- Subjects who, in the opinion of the investigator, are unable and/or unlikely to comprehend and follow the study procedures and instructions.
- Presence of any other co-morbid primary DSM IV disorder.
Sites / Locations
- Shanti Clinical Trials
- Center for Healing the Human Spirit
- Brain Resource Center
- Brain Resource Center
- Skyland Behavioral Health Associates , P.A.
- Brain Dynamics Centre
- Brainclinics Diagnostics B.V.
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
No Intervention
Arm Label
A
B
C
Arm Description
Short Acting methylphenidate
Long Acting Methylphenidate
Healthy Controls
Outcomes
Primary Outcome Measures
To determine whether the genetic-brain-cognition function markers (or combination of markers) 'normalize' with acute drug treatment in ADHD.
Secondary Outcome Measures
To determine whether markers of acute treatment prediction are also predictive of functional outcome over 6-12 months.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00863499
Brief Title
International Study to Predict Optimised Treatment in Attention Deficit/Hyperactivity Disorder
Official Title
International Study to Predict Optimised Treatment Response to Short or Long Acting Methylphenidate in Children and Adolescents With Attention Deficit/Hyperactivity Disorder.
Study Type
Interventional
2. Study Status
Record Verification Date
July 2018
Overall Recruitment Status
Unknown status
Study Start Date
October 2009 (undefined)
Primary Completion Date
December 2019 (Anticipated)
Study Completion Date
December 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BRC Operations Pty. Ltd.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The aim of the iSPOT-A study is to:
identify brain, genetic and cognitive markers of Attention Deficit/Hyperactivity Disorder, and
identify brain, genetic and cognitive markers that predict treatment response to short-acting methylphenidate in children and adolescents diagnosed with Attention Deficit/Hyperactivity Disorder.
Detailed Description
This is a multi-center, open-label effectiveness trial to identify objective indicators of treatment response in ADHD subjects (versus healthy controls) using cognitive and brain function measures, brain structure and genetic measures in subjects diagnosed with ADHD.
At least 672 naïve and treatment experienced subjects with ADHD will be enrolled from approximately 10 primary care centers. These patients are to be outpatients.
In addition, up to 672 healthy (non-ADHD) control subjects will be recruited who match the enrolled ADHD subjects in race, age, gender and years of education.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Attention Deficit/Hyperactivity Disorder
Keywords
Attention Deficit/Hyperactivity Disorder, Attention Deficit Disorder, ADHD, ADD, iSPOT
7. Study Design
Primary Purpose
Health Services Research
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
1344 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
A
Arm Type
Active Comparator
Arm Description
Short Acting methylphenidate
Arm Title
B
Arm Type
Active Comparator
Arm Description
Long Acting Methylphenidate
Arm Title
C
Arm Type
No Intervention
Arm Description
Healthy Controls
Intervention Type
Drug
Intervention Name(s)
Short Acting Methylphenidate
Other Intervention Name(s)
• Ritalin, • Ritalina, • Attenta, • Methylin, • Penid, • Rubifen, *Consider treatment directions above or as physician directed as per usual care.
Intervention Description
Dosage: 5 mg twice daily (before breakfast and lunch) with gradual increments of 5 to 10 mg weekly. Daily dosage above 60 mg is not recommended.
Intervention Type
Drug
Intervention Name(s)
Long Acting Methylphenidate
Other Intervention Name(s)
• Concerta, • Metadate CD, • Methylin ER, • Ritalin LA, • Ritalin Sustained-Release, *Consider treatment directions above or as physician directed as per usual care.
Intervention Description
Dosage: 9 to 20 mg once daily in the morning (with or without food) with gradual increments of 9 to 20 mg weekly. Daily dosage above 60 mg is not recommended.
Primary Outcome Measure Information:
Title
To determine whether the genetic-brain-cognition function markers (or combination of markers) 'normalize' with acute drug treatment in ADHD.
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
To determine whether markers of acute treatment prediction are also predictive of functional outcome over 6-12 months.
Time Frame
52 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Subjects who have signed an informed consent or assent form where required and/or whose parent or legal guardian has provided written informed consent.
Subjects who meet DSM-IV criteria for primary diagnosis of ADHD at study entry, as determined by a psychiatrist, physician or clinical psychologist in conjunction with the clinical work-up undertaken by trained research assistants, as defined by The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid).
Subjects who score at least 6 Inattentive or Hyperactive/impulsive items >1 on the Attention Deficit / Hyperactivity Disorder Rating Scale.
Subjects who are stimulant naïve or stimulant free (defined as no stimulant medication in the previous 7 days*).
Subjects who are 6-17 years of age (with an emphasis to enrol at least a third of the subjects who are ≥ 13 years of age).
Subjects who are fluent and literate in English (and/or Dutch in The Netherlands).
coming off the stimulant medication for 7 days may place the participant at increased risk, therefore, the participant may have this washout period reduced to that defined in the drug package insert or 5 times the medication half life.
Exclusion Criteria:
Known contra-indication or intolerance to the use of methylphenidate as defined in the product package insert (including previous treatment failure at the highest recommended dose).
Pregnancy and females of child bearing potential who are not using a form of contraception and are at risk of becoming pregnant during the study.
Known medical condition, disease or neurological disorder which might, in the opinion of investigator/s, interfere with the assessments to be made in the study or put ADHD patients at increased risk when exposed to optimal doses of the drug treatment. For example, a diagnosis of epilepsy would exclude a patient from this trial.
History of physical brain injury or blow to the head that resulted in loss of consciousness for at least 10 minutes or at least 5minutes within the last two years. Prior treatment with methylphenidate or any other stimulant medication in the past 7 days.
Known past or present substance dependence, including alcohol, as determined by The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid).
Participation in an investigational study within four months of the baseline visit in which subjects have received an experimental drug/device that could affect the primary end points of this study.
Use of any psychological or counselling therapy or CNS medication that cannot be washed out prior to participation or use of any psychological or counselling therapy between the baseline and week 6 (or Early Termination) visits.
Subjects who, in the opinion of the investigator, have a severe impediment to vision, hearing and/or hand movement, which is likely to interfere with their ability to complete the testing batteries.
Subjects who, in the opinion of the investigator, are unable and/or unlikely to comprehend and follow the study procedures and instructions.
Presence of any other co-morbid primary DSM IV disorder.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Barbara A. Cohen, PhD
Organizational Affiliation
Center for Healing the Human Spirit
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Harbans Multani, MD
Organizational Affiliation
Shanti Clinical Trials
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Kamran Fallahpour, PhD
Organizational Affiliation
Brain Resource Center NY
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Martijn Arns, PhD
Organizational Affiliation
Brainclinics Diagnostics B.V.
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mona Ismail, MD
Organizational Affiliation
Brain Resource Center NJ
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Roger deBeus, PhD
Organizational Affiliation
Skyland Behavioral Health Associates
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Simon Clarke, MD
Organizational Affiliation
Brain Dynamics Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shanti Clinical Trials
City
Colton
State/Province
California
ZIP/Postal Code
92324
Country
United States
Facility Name
Center for Healing the Human Spirit
City
Tarzana
State/Province
California
ZIP/Postal Code
91356
Country
United States
Facility Name
Brain Resource Center
City
Englewood Cliffs
State/Province
New Jersey
ZIP/Postal Code
07632
Country
United States
Facility Name
Brain Resource Center
City
New York
State/Province
New York
ZIP/Postal Code
10023
Country
United States
Facility Name
Skyland Behavioral Health Associates , P.A.
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28801
Country
United States
Facility Name
Brain Dynamics Centre
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Brainclinics Diagnostics B.V.
City
Nijmegen
State/Province
Gelderland
ZIP/Postal Code
6524 AD
Country
Netherlands
12. IPD Sharing Statement
Citations:
PubMed Identifier
29937325
Citation
Arns M, Vollebregt MA, Palmer D, Spooner C, Gordon E, Kohn M, Clarke S, Elliott GR, Buitelaar JK. Electroencephalographic biomarkers as predictors of methylphenidate response in attention-deficit/hyperactivity disorder. Eur Neuropsychopharmacol. 2018 Aug;28(8):881-891. doi: 10.1016/j.euroneuro.2018.06.002. Epub 2018 Jun 22.
Results Reference
derived
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International Study to Predict Optimised Treatment in Attention Deficit/Hyperactivity Disorder
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