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An Initial Study of AZD7325 in Adults With Fragile X Syndrome

Primary Purpose

Fragile X Syndrome

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AZD7325 (High-Dose)
AZD7325 (Low-Dose)
Placebo oral capsule
Sponsored by
Children's Hospital Medical Center, Cincinnati
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Fragile X Syndrome

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnostic confirmation of full mutation FXS
  • 50 ≥ Age ≥18 years. Males and Females included in study.
  • General good health as determined by physical exam, medical history and laboratory work up.
  • FXS genetic reports at screening
  • IQ less than or equal to 80. Note: IQ cutoff is used as a means to exclude cases of females with FXS who have the full mutation, but may have neurotypical development (ie: do not have the full FXS phenotype despite positive FXS genetic testing) due to variability in X chromosome inactivation patterns.
  • Male study participants who are sexually active with a female partner of childbearing potential must be surgically sterilized, practicing abstinence, or agree to use highly effective methods of birth control (defined in the list below), and not rely on barrier methods and spermicide alone, from the time of screening until 1 week after final dose of study drug. Male study participants must also not donate sperm from the time of screening until 1 week after final dose of study drug. Given that AZD7325 is not mutagenic, there is no mandatory requirement for condom use, either for avoidance of procreation or in the case of treated males with a pregnant partner.
  • Women of childbearing potential may be included in the study provided they are established on, and continue to use, highly effective contraceptive methods from the time of screening until 1 week after the final dose of study drug. Highly effective methods of contraception associated with inhibition of ovulation (either oral, intravaginal or transdermal), progestin-only hormonal contraception associated with inhibition of ovulation (either oral [specifically Micronor, Nor-QD or their generic equivalents], injectable or implantable).
  • Aberrant Behavior Checklist total score of 20 or higher at screening

Exclusion Criteria:

  • Concomitant use of modulators of GABA A neurotransmission. (examples)
  • Use of more than three psychotropic drugs that do not directly impact GABA transmission, and/or unstable dosing of any psychotropic medication in the 4 weeks prior to baseline visit.
  • Subjects are prohibited from use of strong and moderate modulators of CYP3A and CYP2C19 during the screening (at least 2 weeks before initiation of the study) and treatment periods of the study. Such prohibited drugs are outlined in http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm292362.pdf
  • CNS-suppressing agents such as central analgesics, muscle relaxants, benzodiazepines, other sedatives, and should also limit alcohol intake to ≤1 alcoholic beverage per day.
  • Unstable seizure disorder as defined by any seizure in the 6 months prior to baseline visit and/or a change in any anti-convulsant drug dosing in the 60 days prior to study entry.
  • All patients with abnormal baseline safety lab assessments including, but not limited to ALT or AST greater than 1.5 the upper limit of normal, total bilirubin or creatinine greater than 1 time the upper limit of normal or other clinically relevant lab abnormality or abnormality in ECG, HR or BP at screening as judged by the investigator.
  • Clinical relevant history or presence of any medical disorder judged by the investigator at potentially interfering with this trial.
  • History of or current abuse of drugs or alcohol including prescription medication.
  • For female subjects of child bearing potential (women 50 & under is "amenorrhoeic for 12 months or more (following cessation of exogenous hormonal treatments - if these have been previously taken) and with luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels in the post-menopausal range) a positive pregnancy test.

Sites / Locations

  • Cincinnati Children's Hospital Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Placebo - Low-Dose - High-Dose

Placebo - High-Dose - Low-Dose

Low-Dose - Placebo - High-Dose

Low-Dose - High-Dose - Placebo

High-Dose - Low-Dose - Placebo

High-Dose - Placebo - Low-Dose

Arm Description

Placebo AZD7325 5mg BID in gelatin capsules AZD7325 15mg BID in gelatin capsules

Placebo AZD7325 15mg BID in gelatin capsules AZD7325 5mg BID in gelatin capsules

AZD7325 5mg BID in gelatin capsules Placebo AZD7325 15mg BID in gelatin capsules

AZD7325 5mg BID in gelatin capsules AZD7325 15mg BID in gelatin capsules Placebo

AZD7325 15mg BID in gelatin capsules AZD7325 5mg BID in gelatin capsules Placebo

AZD7325 15mg BID in gelatin capsules Placebo AZD7325 5mg BID in gelatin capsules

Outcomes

Primary Outcome Measures

Amyloid Precursor Protein (APP)
Short-term treatment of peripheral APP dysregulation by correcting elevated levels

Secondary Outcome Measures

Change in the Social Withdrawal subscale score of the Aberrant Behavior Checklist (ABC)
The ABC is the gold standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials.
Change in the Pediatric Anxiety Rating Scale (PARS)
The PARS is the gold standard parent/caregiver reported anxiety outcome measure for use in Fragile X Syndrome clinical trials.

Full Information

First Posted
April 17, 2017
Last Updated
February 3, 2021
Sponsor
Children's Hospital Medical Center, Cincinnati
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1. Study Identification

Unique Protocol Identification Number
NCT03140813
Brief Title
An Initial Study of AZD7325 in Adults With Fragile X Syndrome
Official Title
An Initial Double-Blind, Placebo-Controlled Two-Dose Crossover Study of AZD7325 in Adults With Fragile X Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
January 16, 2018 (Actual)
Primary Completion Date
June 18, 2020 (Actual)
Study Completion Date
June 18, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Children's Hospital Medical Center, Cincinnati

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This study will investigate the safety, tolerability and blood pharmacodynamics of treatment with oral administration of AZD7325 at 5 mg BID, 15 mg BID, and placebo BID, in adults with Fragile X Syndrome. The study also will also investigate measures of efficacy and biomarkers during treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fragile X Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo - Low-Dose - High-Dose
Arm Type
Experimental
Arm Description
Placebo AZD7325 5mg BID in gelatin capsules AZD7325 15mg BID in gelatin capsules
Arm Title
Placebo - High-Dose - Low-Dose
Arm Type
Experimental
Arm Description
Placebo AZD7325 15mg BID in gelatin capsules AZD7325 5mg BID in gelatin capsules
Arm Title
Low-Dose - Placebo - High-Dose
Arm Type
Experimental
Arm Description
AZD7325 5mg BID in gelatin capsules Placebo AZD7325 15mg BID in gelatin capsules
Arm Title
Low-Dose - High-Dose - Placebo
Arm Type
Experimental
Arm Description
AZD7325 5mg BID in gelatin capsules AZD7325 15mg BID in gelatin capsules Placebo
Arm Title
High-Dose - Low-Dose - Placebo
Arm Type
Experimental
Arm Description
AZD7325 15mg BID in gelatin capsules AZD7325 5mg BID in gelatin capsules Placebo
Arm Title
High-Dose - Placebo - Low-Dose
Arm Type
Experimental
Arm Description
AZD7325 15mg BID in gelatin capsules Placebo AZD7325 5mg BID in gelatin capsules
Intervention Type
Drug
Intervention Name(s)
AZD7325 (High-Dose)
Intervention Description
15mg PO BID
Intervention Type
Drug
Intervention Name(s)
AZD7325 (Low-Dose)
Intervention Description
5mg PO BID
Intervention Type
Drug
Intervention Name(s)
Placebo oral capsule
Intervention Description
Placebo will be dosed similar to AZD7325, in terms of dosage form, frequency and duration.
Primary Outcome Measure Information:
Title
Amyloid Precursor Protein (APP)
Description
Short-term treatment of peripheral APP dysregulation by correcting elevated levels
Time Frame
Through end of study, approximately 12 weeks
Secondary Outcome Measure Information:
Title
Change in the Social Withdrawal subscale score of the Aberrant Behavior Checklist (ABC)
Description
The ABC is the gold standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials.
Time Frame
Through end of study, approximately 12 weeks
Title
Change in the Pediatric Anxiety Rating Scale (PARS)
Description
The PARS is the gold standard parent/caregiver reported anxiety outcome measure for use in Fragile X Syndrome clinical trials.
Time Frame
Through end of study, approximately 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnostic confirmation of full mutation FXS 50 ≥ Age ≥18 years. Males and Females included in study. General good health as determined by physical exam, medical history and laboratory work up. FXS genetic reports at screening IQ less than or equal to 80. Note: IQ cutoff is used as a means to exclude cases of females with FXS who have the full mutation, but may have neurotypical development (ie: do not have the full FXS phenotype despite positive FXS genetic testing) due to variability in X chromosome inactivation patterns. Male study participants who are sexually active with a female partner of childbearing potential must be surgically sterilized, practicing abstinence, or agree to use highly effective methods of birth control (defined in the list below), and not rely on barrier methods and spermicide alone, from the time of screening until 1 week after final dose of study drug. Male study participants must also not donate sperm from the time of screening until 1 week after final dose of study drug. Given that AZD7325 is not mutagenic, there is no mandatory requirement for condom use, either for avoidance of procreation or in the case of treated males with a pregnant partner. Women of childbearing potential may be included in the study provided they are established on, and continue to use, highly effective contraceptive methods from the time of screening until 1 week after the final dose of study drug. Highly effective methods of contraception associated with inhibition of ovulation (either oral, intravaginal or transdermal), progestin-only hormonal contraception associated with inhibition of ovulation (either oral [specifically Micronor, Nor-QD or their generic equivalents], injectable or implantable). Aberrant Behavior Checklist total score of 20 or higher at screening Exclusion Criteria: Concomitant use of modulators of GABA A neurotransmission. (examples) Use of more than three psychotropic drugs that do not directly impact GABA transmission, and/or unstable dosing of any psychotropic medication in the 4 weeks prior to baseline visit. Subjects are prohibited from use of strong and moderate modulators of CYP3A and CYP2C19 during the screening (at least 2 weeks before initiation of the study) and treatment periods of the study. Such prohibited drugs are outlined in http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm292362.pdf CNS-suppressing agents such as central analgesics, muscle relaxants, benzodiazepines, other sedatives, and should also limit alcohol intake to ≤1 alcoholic beverage per day. Unstable seizure disorder as defined by any seizure in the 6 months prior to baseline visit and/or a change in any anti-convulsant drug dosing in the 60 days prior to study entry. All patients with abnormal baseline safety lab assessments including, but not limited to ALT or AST greater than 1.5 the upper limit of normal, total bilirubin or creatinine greater than 1 time the upper limit of normal or other clinically relevant lab abnormality or abnormality in ECG, HR or BP at screening as judged by the investigator. Clinical relevant history or presence of any medical disorder judged by the investigator at potentially interfering with this trial. History of or current abuse of drugs or alcohol including prescription medication. For female subjects of child bearing potential (women 50 & under is "amenorrhoeic for 12 months or more (following cessation of exogenous hormonal treatments - if these have been previously taken) and with luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels in the post-menopausal range) a positive pregnancy test.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ernest Pedapati, MD
Organizational Affiliation
Cincinnati Chlidren's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States

12. IPD Sharing Statement

Learn more about this trial

An Initial Study of AZD7325 in Adults With Fragile X Syndrome

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