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Aripiprazole Oral Solution in the Treatment of Children and Adolescents With Autistic Disorder

Primary Purpose

Autistic Disorder

Status
Completed
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Aripiprazole Oral Solution
Placebo Oral Solution
Sponsored by
Otsuka Beijing Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Autistic Disorder focused on measuring Autistic, Aripiprazole Oral Solution

Eligibility Criteria

6 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Written informed consent must be obtained from a legally authorized guardianprior to the initiation of any protocol-required procedures.
  2. The subject and/or the designated guardian(s) or caregiver(s) are able to comprehend and satisfactorily comply with the protocol requirements, in the opinion of the Investigator.
  3. The patient meets current DSM-IV-TR diagnostic criteria for Autistic Disorder and also demonstrates behaviors such as tantrums, aggression, self-injurious behavior, or a combination of these problems. In addition, the Childhood Autism Rating Scale (CARS) score is ≥30.
  4. The subject has a Clinical Global Impressions-Severity (CGI-S) score ≥ 4 AND an ABC-I subscale score ≥18 at screening (Visit 1 or Visit 1a) and baseline (V2).
  5. Environmental factors can be consistent throughout the trial period.
  6. The subject is a male or female child or adolescent 6 to 17 years of age (6 ≤ age ≤ 17) at Baseline (V2).

Exclusion Criteria:

  1. Women of childbearing potential (WOCBP) who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 8 weeks after the study.

    Note: WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal [defined as amenorrhea 12 consecutive months; or women on hormone replacement therapy with documented serum follicle stimulating hormone level ≥ 35 mIU/mL].

  2. Women with a positive pregnancy test or who are pregnant or breastfeeding.
  3. The subject has a current diagnosis of psychotic disorder such as bipolar disorder, schizophrenia, or depression.
  4. The subject is currently diagnosed with another disorder on the autism spectrum, including Pervasive Developmental Disorder-Not Otherwise Specified, Asperger's Disorder, Rett's Disorder, Childhood Disintegrative Disorder or Fragile-X Syndrome.
  5. The subject has a history of neuroleptic malignant syndrome.
  6. The subject represents a significant risk of committing suicide based on history or routine psychiatric status examination.
  7. The subject has had a seizure in the past year or the electroencephalograph examination is epileptiform discharge at screening.
  8. The subject has a history of severe head trauma or stroke;
  9. The subject has a history or current evidence of any unstable medical conditions (eg. history of congenital heart disease or arrhythmia, or cancer) that, in the judgment of the investigator would expose them to undue risk of a significant adverse event (AE) or interfere with assessments of safety or efficacy during the course of the trial.
  10. Non-pharmacological therapy (e.g., psychotherapy, behavior modification, and education training, etc.) could not be stable prior to screening and consistent throughout the study, and the subject who needs to use acupuncture and moxibustion, auditory integration, biofeedback and transcranial magnetic stimulation therapy as supplemental replacement therapy in 7 days prior to taking investigational product or during the course of the trial.
  11. The subject is considered treatment resistant to antipsychotics medication, in the opinion of the Investigator, based on lack of therapeutic response to 2 different antipsychotics with reasonable doses after treatment of at least 3 weeks each.
  12. The subjects considered treatment resistant to aripiprazole in the opinion of the investigator based on lack of therapeutic response to an adequate dose and duration of aripiprazole treatment.
  13. The following laboratory test results, vital sign and Electrocardiograph (ECG) findings are exclusionary:

    • QTc > 450 msec (male), QTc > 470 msec (female)
    • Platelets (below the lower limit)
    • Hemoglobin (below the lower limit)
    • Neutrophils (below the lower limit)
    • AST (SGOT) or ALT (SGPT) (above the upper limit)
    • Creatinine (above the upper limit) In addition, subjects should be excluded if they have any other abnormal laboratory test result, vital sign result or ECG finding that in the investigator's judgment is clinically significant, in that it would impact the safety of the patient or the interpretation of the study results.
  14. The subject weighs < 15 kg.
  15. The subject has a known allergy or hypersensitivity to aripiprazole or other dihydrocarbostyrils (eg. carteolol, vesnarinone, and cilostazol).
  16. The subject has participated in any clinical trials with an investigational agent within the past month.
  17. Subjects who are likely to require prohibited concomitant therapy during the trial (refer to Section 7 Prohibited and Restricted Therapies).
  18. Subjects who participated in a previous clinical trial of aripiprazole (with the exception of Investigator Sponsored Trials).

Sites / Locations

  • 6th affiliated hospital, Peking University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Aripiprazole Oral Solution

Placebo Oral Solution

Arm Description

1 mg/mL, 2 ~ 15 mg/day (2 ~ 15 mL/day), taken once daily for 8 weeks. Administrate about at the same time each day, either before or after meals;

2 ~ 15 mg/day (2 ~ 15 mL/day), taken once daily for 8 weeks. Administrate about at the same time each day, either before or after meals.

Outcomes

Primary Outcome Measures

Changes from Baseline to Week 8 (or endpoint) in the ABC-I score
The objective of the primary analysis is to compare the efficacy of aripiprazole flexible-dosed (2 ~ 15 mg/day) with placebo in reducing serious behavioral problems, specifically irritability, agitation and self-injurious behavior, in children and adolescents with a diagnosis of Autistic Disorder. The efficacy is assessed by assessed by change from baseline to endpoint on the Irritability Subscale of the ABC (ABC-I).

Secondary Outcome Measures

Clinician-rated CGI-I score at Week 8 (or endpoint)
The efficacy is assessed by the clinician-rated CGI-I score at Week 8
Change in ABC subscale scores from Baseline to Week 8 (or endpoint)
The efficacy is assessed by changes from Baseline to Week 8 (or endpoint) in Social Withdrawal, Hyperactivity, Stereotypy and Inappropriate Speech Subscale scores of the ABC
Response Rate at Week 8 (or endpoint) (or endpoint)
The response is defined as a reduction ≥25% in ABC-I score compared to the baseline, and a CGI-I score of much improved or very much improved) at Week 8 (or endpoint).The efficacy is assessed by response rate at Week 8 (or endpoint).

Full Information

First Posted
March 27, 2018
Last Updated
December 24, 2020
Sponsor
Otsuka Beijing Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT03487770
Brief Title
Aripiprazole Oral Solution in the Treatment of Children and Adolescents With Autistic Disorder
Official Title
A Multicenter, Randomized, Double-blind, Flexible-dosed, Placebo-controlled, Parallel-group Clinical Trial Evaluating the Efficacy and Safety of Aripiprazole Oral Solution in Children and Adolescents With Autistic Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
April 9, 2018 (Actual)
Primary Completion Date
April 21, 2020 (Actual)
Study Completion Date
April 21, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Otsuka Beijing Research Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a multicenter, randomized, double-blind, placebo-controlled, parallel-group study to assess the efficacy, safety, tolerability and the steady-state plasma trough concentration of aripiprazole flexible-dosed in children and adolescents with a diagnosis of Autistic Disorder. Approximately 100 subjects will be randomly assigned at a 1:1 ratio to receive aripiprazole (2 to 15 mg) or placebo treatment for 8 weeks
Detailed Description
Screening Phase: up to 42 days (consisting of a Screening Visit (V1), a washout period and Interim Screening Visit (V1a) when applicable, and a Baseline Visit (V2). The Screening Phase will serve multiple purposes: to allow for appropriate washout of prohibited medications; to allow for review of screening data; to establish a pre-treatment baseline of key outcome measures. Treatment Phase: The duration of the treatment is 8 weeks. The purpose of the treatment phase is to evaluate the efficacy, safety, tolerability and steady-state plasma trough concentration of aripiprazole in the treatment of serious behavioral problems in children and adolescents with a diagnosis of Autistic Disorder.. Safety Follow-up Phase: All subjects will be followed up for safety (adverse events) at Day 16 after the last medication via telephone.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autistic Disorder
Keywords
Autistic, Aripiprazole Oral Solution

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Aripiprazole Oral Solution
Arm Type
Experimental
Arm Description
1 mg/mL, 2 ~ 15 mg/day (2 ~ 15 mL/day), taken once daily for 8 weeks. Administrate about at the same time each day, either before or after meals;
Arm Title
Placebo Oral Solution
Arm Type
Placebo Comparator
Arm Description
2 ~ 15 mg/day (2 ~ 15 mL/day), taken once daily for 8 weeks. Administrate about at the same time each day, either before or after meals.
Intervention Type
Drug
Intervention Name(s)
Aripiprazole Oral Solution
Other Intervention Name(s)
Abilify, Aripiprazole
Intervention Description
Aripiprazole 2~15 mg/day (2~15 mL/day)
Intervention Type
Drug
Intervention Name(s)
Placebo Oral Solution
Other Intervention Name(s)
Placebo
Intervention Description
Placebo 2~15 mg/day (2~15 mL/day)
Primary Outcome Measure Information:
Title
Changes from Baseline to Week 8 (or endpoint) in the ABC-I score
Description
The objective of the primary analysis is to compare the efficacy of aripiprazole flexible-dosed (2 ~ 15 mg/day) with placebo in reducing serious behavioral problems, specifically irritability, agitation and self-injurious behavior, in children and adolescents with a diagnosis of Autistic Disorder. The efficacy is assessed by assessed by change from baseline to endpoint on the Irritability Subscale of the ABC (ABC-I).
Time Frame
Baseline and 8 weeks (or endpoint)
Secondary Outcome Measure Information:
Title
Clinician-rated CGI-I score at Week 8 (or endpoint)
Description
The efficacy is assessed by the clinician-rated CGI-I score at Week 8
Time Frame
Baseline and 8 weeks (or endpoint)
Title
Change in ABC subscale scores from Baseline to Week 8 (or endpoint)
Description
The efficacy is assessed by changes from Baseline to Week 8 (or endpoint) in Social Withdrawal, Hyperactivity, Stereotypy and Inappropriate Speech Subscale scores of the ABC
Time Frame
Baseline and 8 weeks (or endpoint)
Title
Response Rate at Week 8 (or endpoint) (or endpoint)
Description
The response is defined as a reduction ≥25% in ABC-I score compared to the baseline, and a CGI-I score of much improved or very much improved) at Week 8 (or endpoint).The efficacy is assessed by response rate at Week 8 (or endpoint).
Time Frame
Baseline and 8 weeks (or endpoint)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent must be obtained from a legally authorized guardianprior to the initiation of any protocol-required procedures. The subject and/or the designated guardian(s) or caregiver(s) are able to comprehend and satisfactorily comply with the protocol requirements, in the opinion of the Investigator. The patient meets current DSM-IV-TR diagnostic criteria for Autistic Disorder and also demonstrates behaviors such as tantrums, aggression, self-injurious behavior, or a combination of these problems. In addition, the Childhood Autism Rating Scale (CARS) score is ≥30. The subject has a Clinical Global Impressions-Severity (CGI-S) score ≥ 4 AND an ABC-I subscale score ≥18 at screening (Visit 1 or Visit 1a) and baseline (V2). Environmental factors can be consistent throughout the trial period. The subject is a male or female child or adolescent 6 to 17 years of age (6 ≤ age ≤ 17) at Baseline (V2). Exclusion Criteria: Women of childbearing potential (WOCBP) who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 8 weeks after the study. Note: WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal [defined as amenorrhea 12 consecutive months; or women on hormone replacement therapy with documented serum follicle stimulating hormone level ≥ 35 mIU/mL]. Women with a positive pregnancy test or who are pregnant or breastfeeding. The subject has a current diagnosis of psychotic disorder such as bipolar disorder, schizophrenia, or depression. The subject is currently diagnosed with another disorder on the autism spectrum, including Pervasive Developmental Disorder-Not Otherwise Specified, Asperger's Disorder, Rett's Disorder, Childhood Disintegrative Disorder or Fragile-X Syndrome. The subject has a history of neuroleptic malignant syndrome. The subject represents a significant risk of committing suicide based on history or routine psychiatric status examination. The subject has had a seizure in the past year or the electroencephalograph examination is epileptiform discharge at screening. The subject has a history of severe head trauma or stroke; The subject has a history or current evidence of any unstable medical conditions (eg. history of congenital heart disease or arrhythmia, or cancer) that, in the judgment of the investigator would expose them to undue risk of a significant adverse event (AE) or interfere with assessments of safety or efficacy during the course of the trial. Non-pharmacological therapy (e.g., psychotherapy, behavior modification, and education training, etc.) could not be stable prior to screening and consistent throughout the study, and the subject who needs to use acupuncture and moxibustion, auditory integration, biofeedback and transcranial magnetic stimulation therapy as supplemental replacement therapy in 7 days prior to taking investigational product or during the course of the trial. The subject is considered treatment resistant to antipsychotics medication, in the opinion of the Investigator, based on lack of therapeutic response to 2 different antipsychotics with reasonable doses after treatment of at least 3 weeks each. The subjects considered treatment resistant to aripiprazole in the opinion of the investigator based on lack of therapeutic response to an adequate dose and duration of aripiprazole treatment. The following laboratory test results, vital sign and Electrocardiograph (ECG) findings are exclusionary: QTc > 450 msec (male), QTc > 470 msec (female) Platelets (below the lower limit) Hemoglobin (below the lower limit) Neutrophils (below the lower limit) AST (SGOT) or ALT (SGPT) (above the upper limit) Creatinine (above the upper limit) In addition, subjects should be excluded if they have any other abnormal laboratory test result, vital sign result or ECG finding that in the investigator's judgment is clinically significant, in that it would impact the safety of the patient or the interpretation of the study results. The subject weighs < 15 kg. The subject has a known allergy or hypersensitivity to aripiprazole or other dihydrocarbostyrils (eg. carteolol, vesnarinone, and cilostazol). The subject has participated in any clinical trials with an investigational agent within the past month. Subjects who are likely to require prohibited concomitant therapy during the trial (refer to Section 7 Prohibited and Restricted Therapies). Subjects who participated in a previous clinical trial of aripiprazole (with the exception of Investigator Sponsored Trials).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patyman Juma
Organizational Affiliation
Otsuka Beijing Research Institute
Official's Role
Study Director
Facility Information:
Facility Name
6th affiliated hospital, Peking University
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100191
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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Aripiprazole Oral Solution in the Treatment of Children and Adolescents With Autistic Disorder

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