CBDV vs Placebo in Children and Adults up to Age 30 With Prader-Willi Syndrome (PWS)
Primary Purpose
Prader-Willi Syndrome
Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CBDV Compound
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Prader-Willi Syndrome focused on measuring PWS, Prader- Willi Syndrome, Irritability, CBDV, Cannabinoids
Eligibility Criteria
Inclusion Criteria
- Male or Female outpatients aged 5 to 30 years.
- Diagnosis of PWS confirmed by genetic testing and patient medical records and history.
- Stable pharmacologic, educational, behavioral and/or dietary interventions for 4 weeks prior to the study start, and for the duration of the study.
- Have a physical exam and laboratory results that are within the norms for PWS
- Presence of a parent/caregiver/guardian that is able to consent for their participation and complete assessments regarding the patient's development and behavior throughout the study. Child Assent will be obtained if the subject is 7 years of age or older and has the mental capacity to understand and sign a written assent form and/or give verbal assent.
- Score on the Clinical Global Impression Scale Severity (CGI-S) ≥ 4 (moderate severity) at baseline.
- Score of ≥18 on the Aberrant Behavior Checklist-Irritability (ABC-I) at baseline.
- Agree not to drive or operate machinery.
Exclusion Criteria
- Exposure to any investigational agent in the 30 days prior to randomization.
- Prior chronic treatment with CBD or CBDV.
- Positive testing for THC or other drugs of abuse via urine testing at the screening visit or baseline visits upon repeat confirmation testing.
- History of Drug Abuse Disorder including Cannabis Use Disorder
- A primary psychiatric diagnosis other than PWS, including bipolar disorder, psychosis, schizophrenia, PTSD or MDD. These patients will be excluded due to potential confounding results.
- A medical condition that severely impacts the subject's ability to participate in the study, interferes with the conduct of the study, confounds interpretation of study results or endangers the subject's well-being (including but not limited to hepatic or renal impairment and cardiovascular disease).
- Known or suspected allergy to CBDV or excipients used in the formulation (i.e. sesame).
- Clinical indications of renal, pancreatic, or hematologic dysfunction as evidenced by values above upper limits of normal for BUN/creatinine, values twice the upper limit of normal for serum lipase and amylase, platelets <80,000 /mcL, WBC<3.0 103 /mcL. or > 2 X UNL values of AST or ALT.
- ECG abnormality at baseline screening or clinically significant postural drop in systolic blood pressure at screening. If the initial screening ECG shows a QTcB of greater than 460 msec, then 2 additional ECGs will be conducted in the same sitting, 5 minutes apart. If not recognized at screening, then a full triplicate repeat showing an average QTcB of 460 msec or less to meet all inclusion/exclusion criteria
- Female subjects who are pregnant will be excluded from the study. If a female subject is able to become pregnant, she will be given a pregnancy test before entry into the study. Female subjects will be informed not become pregnant while taking CBDV. Female subjects must tell the investigator and consult an obstetrician or maternal-fetal specialist if they become pregnant during the study.
Sites / Locations
- Montefiore Medical Center, Albert Einstein College of Medicine
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Cannabidivarin (CBDV)
Matched Placebo
Arm Description
Weight-based dosing of 10 mg/kg/day of CBDV for 12 weeks
Weight-based dosing of 10 mg/kg/day of placebo for 12 weeks
Outcomes
Primary Outcome Measures
Aberrant Behavior Checklist-Irritability Subscale (ABC-I)
Change in the ABC-I score. The ABC-I is a well-characterized outcome that is accepted by the FDA for the purpose of labeling, and is one of the best and most validated outcome measures in the developmental disabilities. An inclusion cutoff of 18 or higher on the ABC-I at screening was chosen based on multiple medication trials with irritability as the primary target.
Secondary Outcome Measures
Repetative Behavior Scale- Revised (RBS-R)
Change in RBS-R score (a 44-item self-report questionnaire that is used to measure the breadth or repetitive behaviors)
Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)
Change in the CY-BOCS score. The CY-BOCS is 10-item clinician measure designed to assess the severity of obsessive compulsive symptoms in children and adolescents over the previous week. It consists of four primary sections including Obsessions checklist, Severity items for Obsessions, Compulsions checklist and severity items for Compulsions and a set of investigational items. Improvement on this scale was associated with improvements in caregiver quality of life in our 8-week study of intranasal oxytocin.
Hyperphagia Questionnaire for Clinical Trials (HQ-CT)
Change in HQ-CT score. The HQ-CT is a 9-item caregiver-reported measure of food-seeking behaviors that was used in the phase 3 beloranib trial.
ActiGraph GT9X-BT activity monitors
Change in Sleep Behaviors. Actigraph activity monitors are a well validated activity sleep monitoring device that has been utilized widely in clinical trials and health research, measuring sleep latency, total sleep time, and sleep efficiency.
Clinical Global Impression Scale - Improvement (CGI-I)
The CGI-I will be used as a measure of improvement and contains a 7 point scale as follows: 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, 7 = very much worse. The CGI-I is a clinician rated global measure of improvement and has been used as a measure in previous clinical psychopharmacology trials.
Caregiver Strain Questionnaire (CSQ)
The Caregiver Strain questionnaire is a 21-item self-report questionnaire that was developed to assess caregiver strain for families with a child living with an emotional or behavioral disorder.
Montefiore Einstein Rigidity Scale-Revised-PWS (MERS-R-PWS)
The Montefiore-Einstein Rigidity Scale-Revised-PWS (MERS-R-PWS) is designed to assess three domains of rigid behavior in individuals with PWS:
Behavioral Rigidity (e.g., Insistence on sameness, things must be done in his/her way, etc.)
Cognitive Rigidity (e.g., Special interests, inflexible adherence to rules, etc.)
Protest (in response to deviation from rigidity; e.g., tantrum, irritability, arguing) The MERS-R-PWS is a clinician-rated scale and takes about 20 minutes to complete. It will be completed only for subjects who display rigid behaviors at baseline, week 4, week 8 and week 12.
Aberrant Behavior Checklist (ABC) subscales in lethargy/social withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech
The ABC is an informative rating instrument that was empirically derived by principal component analysis to measure behavior in those with developmental disability and ASD. It contains 58 items that resolve into 5 subscales. The subscales and the respective number of items are as follows: (a) irritability - 15 items, (b) lethargy/social withdrawal - 16 items, (c) stereotypic behavior - 7 items, (d) hyperactivity/noncompliance - 16 items, and (e) inappropriate speech - 4 items. The ABC was designed to be completed by any adult who knows the patient well, such as a parent/caregiver or teacher. This instrument measures behavior on a four-point severity scale where 0 = no problem at all, 1 = behavior is a problem but in a slight degree, 2 = problem is moderately serious, and 3 = problem is severe in degree.
Full Information
NCT ID
NCT03848481
First Posted
February 19, 2019
Last Updated
October 18, 2023
Sponsor
Montefiore Medical Center
Collaborators
Foundation for Prader-Willi Research, Jazz Pharmaceuticals
1. Study Identification
Unique Protocol Identification Number
NCT03848481
Brief Title
CBDV vs Placebo in Children and Adults up to Age 30 With Prader-Willi Syndrome (PWS)
Official Title
Cannabidivarin (CBDV) vs. Placebo in Children and Adults up to Age 30 With Prader-Willi Syndrome (PWS)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 23, 2020 (Actual)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
October 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Montefiore Medical Center
Collaborators
Foundation for Prader-Willi Research, Jazz Pharmaceuticals
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study aims to examine the feasibility and safety of cannabidivarin (CBDV) as a treatment for children and young adults with PWS.
Detailed Description
This clinical research trial aims to study the feasibility and safety of cannabidivarin (CBDV), in children and young adults with Prader-Willi Syndrome (PWS). CBDV has effects independent of CB1 and CB2 receptor activation and a good safety profile. This proposal addresses the Foundation for Prader Willi Research's PWS Research Plan: Program 1, Clinical Care Research: seeks to evaluate treatments that aim to reduce behavioral symptoms, such as irritability, in order to improve the quality of life of both the individual with PWS and their families. GW Pharmaceuticals will provide the CBDV drug and matching placebo.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prader-Willi Syndrome
Keywords
PWS, Prader- Willi Syndrome, Irritability, CBDV, Cannabinoids
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
14 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cannabidivarin (CBDV)
Arm Type
Experimental
Arm Description
Weight-based dosing of 10 mg/kg/day of CBDV for 12 weeks
Arm Title
Matched Placebo
Arm Type
Placebo Comparator
Arm Description
Weight-based dosing of 10 mg/kg/day of placebo for 12 weeks
Intervention Type
Drug
Intervention Name(s)
CBDV Compound
Intervention Description
CBDV is obtained from the Cannabis sativa L. plant and contains a negligible quantity (less than 0.2%) of THC
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo oral solution contains matching excipients.
Primary Outcome Measure Information:
Title
Aberrant Behavior Checklist-Irritability Subscale (ABC-I)
Description
Change in the ABC-I score. The ABC-I is a well-characterized outcome that is accepted by the FDA for the purpose of labeling, and is one of the best and most validated outcome measures in the developmental disabilities. An inclusion cutoff of 18 or higher on the ABC-I at screening was chosen based on multiple medication trials with irritability as the primary target.
Time Frame
from Baseline to Week 12
Secondary Outcome Measure Information:
Title
Repetative Behavior Scale- Revised (RBS-R)
Description
Change in RBS-R score (a 44-item self-report questionnaire that is used to measure the breadth or repetitive behaviors)
Time Frame
from Baseline to Week 12
Title
Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)
Description
Change in the CY-BOCS score. The CY-BOCS is 10-item clinician measure designed to assess the severity of obsessive compulsive symptoms in children and adolescents over the previous week. It consists of four primary sections including Obsessions checklist, Severity items for Obsessions, Compulsions checklist and severity items for Compulsions and a set of investigational items. Improvement on this scale was associated with improvements in caregiver quality of life in our 8-week study of intranasal oxytocin.
Time Frame
from Baseline to Week 12
Title
Hyperphagia Questionnaire for Clinical Trials (HQ-CT)
Description
Change in HQ-CT score. The HQ-CT is a 9-item caregiver-reported measure of food-seeking behaviors that was used in the phase 3 beloranib trial.
Time Frame
from Baseline to Week 12
Title
ActiGraph GT9X-BT activity monitors
Description
Change in Sleep Behaviors. Actigraph activity monitors are a well validated activity sleep monitoring device that has been utilized widely in clinical trials and health research, measuring sleep latency, total sleep time, and sleep efficiency.
Time Frame
from Baseline to Week 12
Title
Clinical Global Impression Scale - Improvement (CGI-I)
Description
The CGI-I will be used as a measure of improvement and contains a 7 point scale as follows: 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, 7 = very much worse. The CGI-I is a clinician rated global measure of improvement and has been used as a measure in previous clinical psychopharmacology trials.
Time Frame
from Baseline to Week 12
Title
Caregiver Strain Questionnaire (CSQ)
Description
The Caregiver Strain questionnaire is a 21-item self-report questionnaire that was developed to assess caregiver strain for families with a child living with an emotional or behavioral disorder.
Time Frame
from Baseline to Week 12
Title
Montefiore Einstein Rigidity Scale-Revised-PWS (MERS-R-PWS)
Description
The Montefiore-Einstein Rigidity Scale-Revised-PWS (MERS-R-PWS) is designed to assess three domains of rigid behavior in individuals with PWS:
Behavioral Rigidity (e.g., Insistence on sameness, things must be done in his/her way, etc.)
Cognitive Rigidity (e.g., Special interests, inflexible adherence to rules, etc.)
Protest (in response to deviation from rigidity; e.g., tantrum, irritability, arguing) The MERS-R-PWS is a clinician-rated scale and takes about 20 minutes to complete. It will be completed only for subjects who display rigid behaviors at baseline, week 4, week 8 and week 12.
Time Frame
from Baseline to Week 12
Title
Aberrant Behavior Checklist (ABC) subscales in lethargy/social withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech
Description
The ABC is an informative rating instrument that was empirically derived by principal component analysis to measure behavior in those with developmental disability and ASD. It contains 58 items that resolve into 5 subscales. The subscales and the respective number of items are as follows: (a) irritability - 15 items, (b) lethargy/social withdrawal - 16 items, (c) stereotypic behavior - 7 items, (d) hyperactivity/noncompliance - 16 items, and (e) inappropriate speech - 4 items. The ABC was designed to be completed by any adult who knows the patient well, such as a parent/caregiver or teacher. This instrument measures behavior on a four-point severity scale where 0 = no problem at all, 1 = behavior is a problem but in a slight degree, 2 = problem is moderately serious, and 3 = problem is severe in degree.
Time Frame
from Baseline to Week 12
10. Eligibility
Sex
All
Minimum Age & Unit of Time
5 Years
Maximum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria
Male or Female outpatients aged 5 to 30 years.
Diagnosis of PWS confirmed by genetic testing and patient medical records and history.
Stable pharmacologic, educational, behavioral and/or dietary interventions for 4 weeks prior to the study start, and for the duration of the study.
Have a physical exam and laboratory results that are within the norms for PWS
Presence of a parent/caregiver/guardian that is able to consent for their participation and complete assessments regarding the patient's development and behavior throughout the study. Child Assent will be obtained if the subject is 7 years of age or older and has the mental capacity to understand and sign a written assent form and/or give verbal assent.
Score on the Clinical Global Impression Scale Severity (CGI-S) ≥ 4 (moderate severity) at baseline.
Score of ≥18 on the Aberrant Behavior Checklist-Irritability (ABC-I) at baseline.
Agree not to drive or operate machinery.
Exclusion Criteria
Exposure to any investigational agent in the 30 days prior to randomization.
Prior chronic treatment with CBD or CBDV.
Positive testing for THC or other drugs of abuse via urine testing at the screening visit or baseline visits upon repeat confirmation testing.
History of Drug Abuse Disorder including Cannabis Use Disorder
A primary psychiatric diagnosis other than PWS, including bipolar disorder, psychosis, schizophrenia, PTSD or MDD. These patients will be excluded due to potential confounding results.
A medical condition that severely impacts the subject's ability to participate in the study, interferes with the conduct of the study, confounds interpretation of study results or endangers the subject's well-being (including but not limited to hepatic or renal impairment and cardiovascular disease).
Known or suspected allergy to CBDV or excipients used in the formulation (i.e. sesame).
Clinical indications of renal, pancreatic, or hematologic dysfunction as evidenced by values above upper limits of normal for BUN/creatinine, values twice the upper limit of normal for serum lipase and amylase, platelets <80,000 /mcL, WBC<3.0 103 /mcL. or > 2 X UNL values of AST or ALT.
ECG abnormality at baseline screening or clinically significant postural drop in systolic blood pressure at screening. If the initial screening ECG shows a QTcB of greater than 460 msec, then 2 additional ECGs will be conducted in the same sitting, 5 minutes apart. If not recognized at screening, then a full triplicate repeat showing an average QTcB of 460 msec or less to meet all inclusion/exclusion criteria
Female subjects who are pregnant will be excluded from the study. If a female subject is able to become pregnant, she will be given a pregnancy test before entry into the study. Female subjects will be informed not become pregnant while taking CBDV. Female subjects must tell the investigator and consult an obstetrician or maternal-fetal specialist if they become pregnant during the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eric Hollander, MD
Organizational Affiliation
Montefiore Medical Center/Albert Einstein College of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Montefiore Medical Center, Albert Einstein College of Medicine
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
All IPD that underlie results in a publication
Learn more about this trial
CBDV vs Placebo in Children and Adults up to Age 30 With Prader-Willi Syndrome (PWS)
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