Ecopipam Treatment of Tourette's Syndrome in Subjects 7-17 Years
Primary Purpose
Tourette's Syndrome
Status
Unknown status
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ecopipam
Sponsored by
About this trial
This is an interventional treatment trial for Tourette's Syndrome focused on measuring Tourette's Syndrome, Ecopipam, D1 Receptor, Phase 2
Eligibility Criteria
Inclusion Criteria:• Subjects must have Tourette's Syndrome (TS) based on the clinician-administered Diagnostic Confidence Index (DCI) for TS.
- Subjects must exhibit both motor and vocal tics.
- Subjects must have a minimum score of 20 at both Screening and Baseline (just prior to the first treatment) on the Yale Global Tic Severity Scale.
- Subjects must be age (≥ 7 to < 18 years of age)
- Subjects must weigh ≥ 20 kg (45 lbs)
- Adolescent females of childbearing potential who are sexually active must be using effective contraception (i.e., oral contraceptives, intrauterine device, double barrier method of condom and spermicide) and agree to continue use of contraception for the duration of their participation in the study. They must also agree to use contraception for 30 days after their last dose of study drug.
- Sexually active male subjects must use a barrier method of contraception during the study and agree to continue the use of male contraception for at least 30 days after the last dose of study drug.
- Subject's parent or legal guardian must execute a written informed consent.
- Subject must execute a written informed assent.
Exclusion Criteria:
- Subjects who have unstable medical illness or clinically significant abnormalities on laboratory tests, or ECG at Screening.
- Subjects with a major depressive episode in the past 2 years
- Subjects with a history of attempted suicide
- Subjects with clinically significant suicidality (based on the Columbia Suicide Rating Scale (C-SSRS)
- Subjects with a first-degree relative with a major depressive episode that resulted in any psychiatric hospitalization, or attempted/ completed suicide with the exception of a hospitalization for post-partum depression.
- Subjects with a history of seizures (excluding febrile seizures that occurred >2 years in the past)
- Subjects with a myocardial infarction within 6 months.
- Girls who are currently pregnant or lactating.
- Subjects who have a need for medication (other than ecopipam) with possible effects on TS symptoms (i.e., lithium, psychostimulants)
- Subjects who have a need for medications which would have unfavorable interactions with ecopipam, e.g., dopamine antagonists or agonists [including bupropion], tetrabenazine, or monoamine oxidase inhibitors.
- Subjects with a lifetime history of bipolar disorder type I or II, dementia, schizophrenia, or any psychotic disorder determined by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - 4th Edition (DSM-IV) Axis-I Disorders (SCID).
- Subjects with current or recent (past 3 months) DSM-IV substance abuse or dependence (with the exception of nicotine).
- Subjects with positive urine drug screen (cocaine, amphetamine, methamphetamine, tetrahydrocannabinol (THC), benzodiazepines, barbiturates, phencyclidine (PCP), opiates) at Screening. Subjects with urine positive only for benzodiazepines and/or marijuana (i.e., a user but not an abuser as based on DSM-IV criteria) may be eligible.
- Subjects who have had previous treatment with ecopipam.
Subjects who have had treatment with:
- investigational medication within 3 months of starting study
- depot neuroleptics within 3 months of starting study
- other psychotropics with possible effects on TS symptoms (i.e., lithium, tetrabenazine) within 2 weeks prior to Screening.
- oral neuroleptics within 4 weeks
- selective serotonin reuptake inhibitors unless the dosage has been stable for a minimum of 4 weeks prior to study start and not prescribed to relieve the neurological signs of TS
Sites / Locations
- UCLA
- University of South Florida/Rothman Center for Neuropsychiatry
- Emory University School Of Medicine
- University of Chicago Medical School
- Children's Mercy Kansas City
- Washington University School of Medicine
- Overlook Hospital
- North Shore-Long Island Jewish Hosptial
- Weill Cornell Medical School
- Cincinnati Children's Hospital
- Baylor College of Medicine
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Ecopipam
Placebo
Arm Description
Ecopipam is a selective antagonist of the dopamine D1/D5 receptor family that is being studied as a treatment for Tourette's Syndrome
Placebo is the inactive comparator
Outcomes
Primary Outcome Measures
Yale Global Tic Severity Scale
The Yale Global Tic Severity Scale (YGTSS) is the standard rating scale used to assess the effects of a new treatment on the symptoms of Tourette's Syndrome.
Secondary Outcome Measures
Safety
Safety will be assessed by monitoring and recording all Adverse Events (AE) and serious adverse events (SAE), regular monitoring of hematology, blood chemistry, and urine values, regular measurement of vital signs and the performance of a physical examination and an ECG
DuPaul ADHD rating scale-IV
This is a validated rating scale for the symptoms of attention deficit disorder. This is included because people with Tourette's often have attention deficit hyperactivity disorder (ADHD) as well.
Child Yale-Brown Obsessive Compulsive Scale
This is validated rating scale which measures symptoms of obsessive-compulsive behaviors. People with Tourette's often also show symptoms of obsessive-compulsive behaviors.
Children's Depression Inventory
The Children's Depression Inventory is a validate rating scale which measures signs of depression of in children. People with Tourette's often report feelings of depression. In addition, treatment with ecopipam has been reported to increase signs of depression in some patients.
Clinical Global Impression - Improvement and Severity Scales
Clinical Global Impression Scales (improvement and severity) are validated rating scales that measure whether the treatment improves the symptoms of the disease (CGI-I) and whether the treatment reduces the severity of the disease (CGI-S)
Columbia-Suicide Severity Rating Scale
The Columbia Suicide Severity Rating Scale is a validated rating scale which measures feelings of suicide.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02102698
Brief Title
Ecopipam Treatment of Tourette's Syndrome in Subjects 7-17 Years
Official Title
Ecopipam Treatment of Tourette's Syndrome in Subjects 7-17 Years
Study Type
Interventional
2. Study Status
Record Verification Date
November 2016
Overall Recruitment Status
Unknown status
Study Start Date
March 2014 (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
Psyadon Pharma
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Tourette's Syndrome is a neurological disease characterized by motor and vocal tics. It has been hypothesized that abnormal interactions of dopamine with its receptors may cause the tics. The purpose of this study is to test the hypothesis that a drug (ecopipam) that selectively blocks dopamine D1/D5 receptors can reduce the frequency and severity of the tics.
Detailed Description
This is a double blind, randomized, placebo-controlled crossover study to determine whether ecopipam can reduce the symptoms of Tourette's in children age 7-17 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tourette's Syndrome
Keywords
Tourette's Syndrome, Ecopipam, D1 Receptor, Phase 2
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
40 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ecopipam
Arm Type
Experimental
Arm Description
Ecopipam is a selective antagonist of the dopamine D1/D5 receptor family that is being studied as a treatment for Tourette's Syndrome
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo is the inactive comparator
Intervention Type
Drug
Intervention Name(s)
Ecopipam
Other Intervention Name(s)
SCH 39166, PSYRX101
Intervention Description
Ecopipam is a selective antagonist of the dopamine D1 receptor family.
Primary Outcome Measure Information:
Title
Yale Global Tic Severity Scale
Description
The Yale Global Tic Severity Scale (YGTSS) is the standard rating scale used to assess the effects of a new treatment on the symptoms of Tourette's Syndrome.
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Safety
Description
Safety will be assessed by monitoring and recording all Adverse Events (AE) and serious adverse events (SAE), regular monitoring of hematology, blood chemistry, and urine values, regular measurement of vital signs and the performance of a physical examination and an ECG
Time Frame
30 days
Title
DuPaul ADHD rating scale-IV
Description
This is a validated rating scale for the symptoms of attention deficit disorder. This is included because people with Tourette's often have attention deficit hyperactivity disorder (ADHD) as well.
Time Frame
30 days
Title
Child Yale-Brown Obsessive Compulsive Scale
Description
This is validated rating scale which measures symptoms of obsessive-compulsive behaviors. People with Tourette's often also show symptoms of obsessive-compulsive behaviors.
Time Frame
30 days
Title
Children's Depression Inventory
Description
The Children's Depression Inventory is a validate rating scale which measures signs of depression of in children. People with Tourette's often report feelings of depression. In addition, treatment with ecopipam has been reported to increase signs of depression in some patients.
Time Frame
30 days
Title
Clinical Global Impression - Improvement and Severity Scales
Description
Clinical Global Impression Scales (improvement and severity) are validated rating scales that measure whether the treatment improves the symptoms of the disease (CGI-I) and whether the treatment reduces the severity of the disease (CGI-S)
Time Frame
30 days
Title
Columbia-Suicide Severity Rating Scale
Description
The Columbia Suicide Severity Rating Scale is a validated rating scale which measures feelings of suicide.
Time Frame
30 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
7 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:• Subjects must have Tourette's Syndrome (TS) based on the clinician-administered Diagnostic Confidence Index (DCI) for TS.
Subjects must exhibit both motor and vocal tics.
Subjects must have a minimum score of 20 at both Screening and Baseline (just prior to the first treatment) on the Yale Global Tic Severity Scale.
Subjects must be age (≥ 7 to < 18 years of age)
Subjects must weigh ≥ 20 kg (45 lbs)
Adolescent females of childbearing potential who are sexually active must be using effective contraception (i.e., oral contraceptives, intrauterine device, double barrier method of condom and spermicide) and agree to continue use of contraception for the duration of their participation in the study. They must also agree to use contraception for 30 days after their last dose of study drug.
Sexually active male subjects must use a barrier method of contraception during the study and agree to continue the use of male contraception for at least 30 days after the last dose of study drug.
Subject's parent or legal guardian must execute a written informed consent.
Subject must execute a written informed assent.
Exclusion Criteria:
Subjects who have unstable medical illness or clinically significant abnormalities on laboratory tests, or ECG at Screening.
Subjects with a major depressive episode in the past 2 years
Subjects with a history of attempted suicide
Subjects with clinically significant suicidality (based on the Columbia Suicide Rating Scale (C-SSRS)
Subjects with a first-degree relative with a major depressive episode that resulted in any psychiatric hospitalization, or attempted/ completed suicide with the exception of a hospitalization for post-partum depression.
Subjects with a history of seizures (excluding febrile seizures that occurred >2 years in the past)
Subjects with a myocardial infarction within 6 months.
Girls who are currently pregnant or lactating.
Subjects who have a need for medication (other than ecopipam) with possible effects on TS symptoms (i.e., lithium, psychostimulants)
Subjects who have a need for medications which would have unfavorable interactions with ecopipam, e.g., dopamine antagonists or agonists [including bupropion], tetrabenazine, or monoamine oxidase inhibitors.
Subjects with a lifetime history of bipolar disorder type I or II, dementia, schizophrenia, or any psychotic disorder determined by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - 4th Edition (DSM-IV) Axis-I Disorders (SCID).
Subjects with current or recent (past 3 months) DSM-IV substance abuse or dependence (with the exception of nicotine).
Subjects with positive urine drug screen (cocaine, amphetamine, methamphetamine, tetrahydrocannabinol (THC), benzodiazepines, barbiturates, phencyclidine (PCP), opiates) at Screening. Subjects with urine positive only for benzodiazepines and/or marijuana (i.e., a user but not an abuser as based on DSM-IV criteria) may be eligible.
Subjects who have had previous treatment with ecopipam.
Subjects who have had treatment with:
investigational medication within 3 months of starting study
depot neuroleptics within 3 months of starting study
other psychotropics with possible effects on TS symptoms (i.e., lithium, tetrabenazine) within 2 weeks prior to Screening.
oral neuroleptics within 4 weeks
selective serotonin reuptake inhibitors unless the dosage has been stable for a minimum of 4 weeks prior to study start and not prescribed to relieve the neurological signs of TS
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donald Gilbert, MD
Organizational Affiliation
Children's Hospital Medical Center, Cincinnati
Official's Role
Study Chair
Facility Information:
Facility Name
UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90024
Country
United States
Facility Name
University of South Florida/Rothman Center for Neuropsychiatry
City
St. Petersburg
State/Province
Florida
ZIP/Postal Code
33701
Country
United States
Facility Name
Emory University School Of Medicine
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
University of Chicago Medical School
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Children's Mercy Kansas City
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
64108
Country
United States
Facility Name
Washington University School of Medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Overlook Hospital
City
Summit
State/Province
New Jersey
ZIP/Postal Code
07902
Country
United States
Facility Name
North Shore-Long Island Jewish Hosptial
City
Manhasset
State/Province
New York
ZIP/Postal Code
11030
Country
United States
Facility Name
Weill Cornell Medical School
City
New York City
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Cincinnati Children's Hospital
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45228
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
24434529
Citation
Gilbert DL, Budman CL, Singer HS, Kurlan R, Chipkin RE. A D1 receptor antagonist, ecopipam, for treatment of tics in Tourette syndrome. Clin Neuropharmacol. 2014 Jan-Feb;37(1):26-30. doi: 10.1097/WNF.0000000000000017.
Results Reference
background
PubMed Identifier
30192018
Citation
Gilbert DL, Murphy TK, Jankovic J, Budman CL, Black KJ, Kurlan RM, Coffman KA, McCracken JT, Juncos J, Grant JE, Chipkin RE. Ecopipam, a D1 receptor antagonist, for treatment of tourette syndrome in children: A randomized, placebo-controlled crossover study. Mov Disord. 2018 Aug;33(8):1272-1280. doi: 10.1002/mds.27457. Epub 2018 Sep 7.
Results Reference
derived
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Ecopipam Treatment of Tourette's Syndrome in Subjects 7-17 Years
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