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Clinical Efficacy & Safety, of Metadoxine (MG01CI) Extended Release in Attention-Deficit Hyperactivity Disorder (ADHD)

Primary Purpose

ADHD

Status
Completed
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
Metadoxine (MG01CI)
Sponsored by
Alcobra Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for ADHD focused on measuring ADHD,Adults,MG01CI,METADOXINE

Eligibility Criteria

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

Inclusion Criteria:

  1. Adult males and females, 18 to 50 years old, inclusive, at screening visit
  2. Diagnosed with ADHD based on

    1. DSM-IV criteria for ADHD as assessed by the Adult ADHD Clinician Diagnostic Scale (ACDS V1.2)
    2. SCID clinical interview
  3. Clinical severity of at least a moderate level (Clinical Global Impression score of 4 or above)
  4. Female subjects with childbearing potential must agree to use effective contraceptive and have negative urine pregnancy test at screening visit
  5. Able to attend the clinic regularly and reliably
  6. Able to swallow tablets/capsules
  7. Able to understand, read, write and speak Hebrew fluently to complete study related materials
  8. Able to understand and sign written informed consent to participate in the study

Exclusion Criteria:

  1. Subjects who were non-responder to at least two ADHD treatments
  2. Subjects with any medical or psychiatric condition (e.g. schizophrenia, personality disorder as diagnosed by DSM-IV) or clinical significant or unstable medical or surgical condition that may preclude safe and complete study participation as determined by medical history, physical examination, neurological exam, laboratory tests or ECG or based on the opinion of the Investigator; common diseases such as hypertension, type 2 diabetes mellitus, hyperlipidemia, etc. are allowed per the Investigator's judgment, as long as they are stable and controlled by medical therapy that is constant for at least 8 weeks prior to randomization and throughout the study
  3. Any prescription or non-prescription ADHD medications during the 7 days prior to the screening visit
  4. Known or suspected HIV-positive or with advanced diseases such as AIDS, Hepatitis C, Hepatitis B or tuberculosis
  5. History of allergy or sensitivity to B complex vitamins
  6. History or suspicion of PDD, NLD or other psychotic conditions
  7. Use of Vitamin B throughout the study
  8. Use of ADHD medications throughout the study
  9. Use of any psychiatric medications throughout the study
  10. Use of investigational medication/treatment in the past 30 days prior to the screening visit per the discretion of the Investigator
  11. Use of any medication or food supplement not considered acceptable by the clinical Investigator or the medical monitor during the 14-day period before randomization
  12. Current (or history within the last 6 months) of drug dependence or substance abuse disorder according to DSM-IV-TR criteria (excluding nicotine). Subjects should also agree to refrain from consuming abnormally high amounts of caffeine during the study.
  13. Suicidality, defined as either active suicidal plan/intent or active suicidal thoughts, in the 6 months before the Screening Visit or no lifetime suicide attempt.
  14. Blind subjects
  15. Any relation to the Sponsor, Investigator or study staff
  16. Any condition, which in the opinion of the Principal Investigator would place the subject at risk or influence the conduct of the study or interpretation of results, including (but not limited to) abnormally low intellectual capacity.
  17. Subjects who cannot fully comprehend the implications of the protocol or comply with its requirements or are capable to follow the study schedule for any reason
  18. Pregnancy, lactation or inadequate contraceptive method

    -

Sites / Locations

  • Cognitive Neurology unit Rambam Health Care Campus
  • ADHD Unit, Geha Mental Health Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

METADOXINE

Placebo

Arm Description

Eligible subjects will be randomly assigned to receive MG01CI (1,400 mg)

Eligible subjects will be randomly assigned to receive Placebo (1,400 mg)

Outcomes

Primary Outcome Measures

Conners' Adult ADHD Rating Scales (CAARS™)
The primary efficacy endpoint is the difference in change (decrease) in CAARS (Total ADHD Symptoms Score) between the study groups. The CAARS assess the presence and severity of ADHD symptoms and behaviors in adults. Respondents are asked to report their own experiences by rating items pertaining to their behavior/problems using a 4-point Likert-style format ranging from 0 ('Not at all', 'never') to 3 ('Very much', 'very frequently'). The scale measures ADHD symptoms using a 30-item questionnaire.Total score is the sum of all the items ,min=30 Max=90

Secondary Outcome Measures

Test of Variables of Attention (TOVA) (Change in ADHD Score From Screening to Visit 6)
The TOVA is a computerized test that provides information about an individual's sustained attention, speed and consistency of responding, and behavioral self-regulation and executive functioning. ADHD score is a comparison of the subject's response to the CPT test to those of an ADHD group, and is reported as a Z-score. An ADHD score of -1.80 and less fits the profile of the ADHD sample. A score of more than -1.80 (more positive) does not fit the ADHD profile. When comparing ADHD scores the higher the ADHD score the better the performance.
Adult ADHD Quality of Life (AAQoL)- Measuring Change in Total Score of AAQoL From Visit 1 to Visit 6
The AAQoL scale provides a validated disease-specific measure of the impact of ADHD on quality of life.It is scored as an overall score (29 items) and four subscale scores: life productivity (11 items), psychological health (6 items), life outlook (7 items) and relationships (5 items). Individual items are scored on a five-point Likert-like scale from 'Not at all/Never' (1) to 'Extremely/Very Often' (5).
Clinical Global Impression Scale (CGI-I)Score
The CGI is rated on a 7-point scale, with the severity of illness scale using a range of responses from 1 (normal) through to 7 (amongst the most severely ill patients). CGI-I scores range from 1 ('very much improved') through to 7 ('very much worse'). During the conduct of the study, CGI-I evaluations were not done correctly and thus data interpretation is limited.

Full Information

First Posted
November 17, 2010
Last Updated
April 17, 2012
Sponsor
Alcobra Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01243242
Brief Title
Clinical Efficacy & Safety, of Metadoxine (MG01CI) Extended Release in Attention-Deficit Hyperactivity Disorder (ADHD)
Official Title
Randomized, Double-blind, Placebo-controlled, Multi-center Study Designed to Evaluate the Efficacy, Safety and Tolerability of Metadoxine Extended Release in Adults With Attention Deficit Hyperactive Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
April 2012
Overall Recruitment Status
Completed
Study Start Date
February 2011 (undefined)
Primary Completion Date
August 2011 (Actual)
Study Completion Date
September 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alcobra Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate efficacy, safety and tolerability of metadoxine (MG01CI) extended release formulation for the treatment of adults diagnosed with ADHD
Detailed Description
This will be a randomized, double-blind, placebo-controlled, parallel-group, multicenter study in adult subjects with ADHD. Eligible subjects will be randomly assigned in a 1:1 ratio to one of two treatment groups, 1400 mg Metadoxine (MG01CI) and Placebo. The study will consist of three periods: a screening period of up to 2 weeks, a 6-week double-blind treatment period, and a 2-week safety follow-up period. The total duration of subject participation will be ~10 weeks. Overview of Study Visits Screening Period: Visit 1 - Screening/Baseline Visit (up to 14 days prior to dosing) Treatment Period: Visit 2 - Day 0 (Randomization Visit) Visit 3 - Day 7 ± 2 days Visit 4 - Day 14 ± 2 days Visit 5 - Day 28 ± 2 days Visit 6 - Day 42 ± 2 days Follow-up period: Visit 7 - Day 56 ± 3 days

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
ADHD
Keywords
ADHD,Adults,MG01CI,METADOXINE

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
120 (Actual)

8. Arms, Groups, and Interventions

Arm Title
METADOXINE
Arm Type
Experimental
Arm Description
Eligible subjects will be randomly assigned to receive MG01CI (1,400 mg)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Eligible subjects will be randomly assigned to receive Placebo (1,400 mg)
Intervention Type
Drug
Intervention Name(s)
Metadoxine (MG01CI)
Other Intervention Name(s)
Metadoxil
Intervention Description
MG01CI 1400 mg, that will be taken daily by the patients for a duration of 6 weeks.
Primary Outcome Measure Information:
Title
Conners' Adult ADHD Rating Scales (CAARS™)
Description
The primary efficacy endpoint is the difference in change (decrease) in CAARS (Total ADHD Symptoms Score) between the study groups. The CAARS assess the presence and severity of ADHD symptoms and behaviors in adults. Respondents are asked to report their own experiences by rating items pertaining to their behavior/problems using a 4-point Likert-style format ranging from 0 ('Not at all', 'never') to 3 ('Very much', 'very frequently'). The scale measures ADHD symptoms using a 30-item questionnaire.Total score is the sum of all the items ,min=30 Max=90
Time Frame
6 weeks (from visit 1 baseline to visit 6)
Secondary Outcome Measure Information:
Title
Test of Variables of Attention (TOVA) (Change in ADHD Score From Screening to Visit 6)
Description
The TOVA is a computerized test that provides information about an individual's sustained attention, speed and consistency of responding, and behavioral self-regulation and executive functioning. ADHD score is a comparison of the subject's response to the CPT test to those of an ADHD group, and is reported as a Z-score. An ADHD score of -1.80 and less fits the profile of the ADHD sample. A score of more than -1.80 (more positive) does not fit the ADHD profile. When comparing ADHD scores the higher the ADHD score the better the performance.
Time Frame
6 weeks( visit 1 baseline to visit 6)
Title
Adult ADHD Quality of Life (AAQoL)- Measuring Change in Total Score of AAQoL From Visit 1 to Visit 6
Description
The AAQoL scale provides a validated disease-specific measure of the impact of ADHD on quality of life.It is scored as an overall score (29 items) and four subscale scores: life productivity (11 items), psychological health (6 items), life outlook (7 items) and relationships (5 items). Individual items are scored on a five-point Likert-like scale from 'Not at all/Never' (1) to 'Extremely/Very Often' (5).
Time Frame
6 weeks (from visit 1 baseline to visit 6)
Title
Clinical Global Impression Scale (CGI-I)Score
Description
The CGI is rated on a 7-point scale, with the severity of illness scale using a range of responses from 1 (normal) through to 7 (amongst the most severely ill patients). CGI-I scores range from 1 ('very much improved') through to 7 ('very much worse'). During the conduct of the study, CGI-I evaluations were not done correctly and thus data interpretation is limited.
Time Frame
6 weeks from visit 1 baseline to visit 6

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: Adult males and females, 18 to 50 years old, inclusive, at screening visit Diagnosed with ADHD based on DSM-IV criteria for ADHD as assessed by the Adult ADHD Clinician Diagnostic Scale (ACDS V1.2) SCID clinical interview Clinical severity of at least a moderate level (Clinical Global Impression score of 4 or above) Female subjects with childbearing potential must agree to use effective contraceptive and have negative urine pregnancy test at screening visit Able to attend the clinic regularly and reliably Able to swallow tablets/capsules Able to understand, read, write and speak Hebrew fluently to complete study related materials Able to understand and sign written informed consent to participate in the study Exclusion Criteria: Subjects who were non-responder to at least two ADHD treatments Subjects with any medical or psychiatric condition (e.g. schizophrenia, personality disorder as diagnosed by DSM-IV) or clinical significant or unstable medical or surgical condition that may preclude safe and complete study participation as determined by medical history, physical examination, neurological exam, laboratory tests or ECG or based on the opinion of the Investigator; common diseases such as hypertension, type 2 diabetes mellitus, hyperlipidemia, etc. are allowed per the Investigator's judgment, as long as they are stable and controlled by medical therapy that is constant for at least 8 weeks prior to randomization and throughout the study Any prescription or non-prescription ADHD medications during the 7 days prior to the screening visit Known or suspected HIV-positive or with advanced diseases such as AIDS, Hepatitis C, Hepatitis B or tuberculosis History of allergy or sensitivity to B complex vitamins History or suspicion of PDD, NLD or other psychotic conditions Use of Vitamin B throughout the study Use of ADHD medications throughout the study Use of any psychiatric medications throughout the study Use of investigational medication/treatment in the past 30 days prior to the screening visit per the discretion of the Investigator Use of any medication or food supplement not considered acceptable by the clinical Investigator or the medical monitor during the 14-day period before randomization Current (or history within the last 6 months) of drug dependence or substance abuse disorder according to DSM-IV-TR criteria (excluding nicotine). Subjects should also agree to refrain from consuming abnormally high amounts of caffeine during the study. Suicidality, defined as either active suicidal plan/intent or active suicidal thoughts, in the 6 months before the Screening Visit or no lifetime suicide attempt. Blind subjects Any relation to the Sponsor, Investigator or study staff Any condition, which in the opinion of the Principal Investigator would place the subject at risk or influence the conduct of the study or interpretation of results, including (but not limited to) abnormally low intellectual capacity. Subjects who cannot fully comprehend the implications of the protocol or comply with its requirements or are capable to follow the study schedule for any reason Pregnancy, lactation or inadequate contraceptive method -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Iris Manor, MD
Organizational Affiliation
Geha MC, Israel
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cognitive Neurology unit Rambam Health Care Campus
City
Haifa
Country
Israel
Facility Name
ADHD Unit, Geha Mental Health Center
City
Petah Tikva,
Country
Israel

12. IPD Sharing Statement

Citations:
PubMed Identifier
23933905
Citation
Manor I, Newcorn JH, Faraone SV, Adler LA. Efficacy of metadoxine extended release in patients with predominantly inattentive subtype attention-deficit/hyperactivity disorder. Postgrad Med. 2013 Jul;125(4):181-90. doi: 10.3810/pgm.2013.07.2689.
Results Reference
derived
PubMed Identifier
23290324
Citation
Manor I, Ben-Hayun R, Aharon-Peretz J, Salomy D, Weizman A, Daniely Y, Megiddo D, Newcorn JH, Biederman J, Adler LA. A randomized, double-blind, placebo-controlled, multicenter study evaluating the efficacy, safety, and tolerability of extended-release metadoxine in adults with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2012 Dec;73(12):1517-23. doi: 10.4088/JCP.12m07767.
Results Reference
derived

Learn more about this trial

Clinical Efficacy & Safety, of Metadoxine (MG01CI) Extended Release in Attention-Deficit Hyperactivity Disorder (ADHD)

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