Trial Outcomes & Findings for A Within-Subject Cross-Over Comparison Between Immediate Release and Extended Release Adderall (NCT NCT00468143)

NCT ID: NCT00468143

Last Updated: 2016-06-02

Results Overview

Dosage adherence (MEMSd) is the number of bottle openings divided by number of doses prescribed. Adherence was measured as ≥ 75% of the doses. The number below is the total percentage of subjects who were adherent.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

62 participants

Primary outcome timeframe

The MEMS information was noted at clinic visit 3, 4, 5, 7, 8, and 9 (over 8 weeks)

Results posted on

2016-06-02

Participant Flow

Men or women, aged 18 to 55 years, who met the DSM-IV criteria for ADHD, as assessed by the Adult ADHD Clinician Diagnostic Scale (ACDS) version 1.2, were eligible to participate. Participants were recruited from local advertising or from the pool of participants at the MHADRP at NYU School of Medicine and VA NY Harbor Healthcare System.

Individuals who were currently receiving amphetamine or methylphenidate treatment underwent a 7-day washout period before the baseline visit; those receiving atomoxetine or other medications for ADHD were required to undergo a 28-day washout period before the baseline visit. While 62 subjects started the study, only 49 finished the full study.

Participant milestones

Participant milestones
Measure
Extended Release First
This group received the extended release medication during the first three weeks of treatment and then received the immediate release medication during the last 3 weeks of treatment.
Immediate Release First
This group received the immediate release medication during the first three weeks of treatment and then received the extended release medication during the last 3 weeks of treatment.
First Intervention (3 Weeks)
STARTED
31
31
First Intervention (3 Weeks)
COMPLETED
28
27
First Intervention (3 Weeks)
NOT COMPLETED
3
4
Second Intervention (3 Weeks)
STARTED
28
27
Second Intervention (3 Weeks)
COMPLETED
25
24
Second Intervention (3 Weeks)
NOT COMPLETED
3
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Extended Release First
This group received the extended release medication during the first three weeks of treatment and then received the immediate release medication during the last 3 weeks of treatment.
Immediate Release First
This group received the immediate release medication during the first three weeks of treatment and then received the extended release medication during the last 3 weeks of treatment.
First Intervention (3 Weeks)
Withdrawal by Subject
3
4
Second Intervention (3 Weeks)
Withdrawal by Subject
3
3

Baseline Characteristics

A Within-Subject Cross-Over Comparison Between Immediate Release and Extended Release Adderall

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Participants
n=62 Participants
This was a randomized, crossover study in which participants received 3 weeks of treatment with MAS IR (15, 30, or 45 mg TID) and 3 weeks of treatment with MAS XR (15, 30, or 45 mg qAM). The order of the treatments (TID-qAM or qAM-TID) was counterbalanced across participants, with a washout period of ≥ 7 days between epochs.
Age, Continuous
35.7 years
STANDARD_DEVIATION 10.3 • n=99 Participants
Sex: Female, Male
Female
28 Participants
n=99 Participants
Sex: Female, Male
Male
34 Participants
n=99 Participants
Race/Ethnicity, Customized
Caucasian
46 Participants
n=99 Participants
Race/Ethnicity, Customized
African American
7 Participants
n=99 Participants
Race/Ethnicity, Customized
Hispanic
5 Participants
n=99 Participants
Race/Ethnicity, Customized
Asian
4 Participants
n=99 Participants

PRIMARY outcome

Timeframe: The MEMS information was noted at clinic visit 3, 4, 5, 7, 8, and 9 (over 8 weeks)

Population: These is the total of participants who completed the study.

Dosage adherence (MEMSd) is the number of bottle openings divided by number of doses prescribed. Adherence was measured as ≥ 75% of the doses. The number below is the total percentage of subjects who were adherent.

Outcome measures

Outcome measures
Measure
Adderall IR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (5 mg TID for Adderall IR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Adderall XR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (15 mg qAM for Adderall XR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Medication Event Monitoring System (MEMS®) Dosage Adherence
42.7 percentage of participants adherent
66.2 percentage of participants adherent

PRIMARY outcome

Timeframe: The MEMS information was noted at clinic visit 3, 4, 5, 7, 8, and 9 (over 8 weeks)

Regimen adherence (MEMSr) is a percentage of the number of days in which the complete dose regimen was taken as prescribed. Adherence was measured as complete dose regimen taken on ≥ 90% of days. The number below is the total percentage of subjects who were adherent.

Outcome measures

Outcome measures
Measure
Adderall IR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (5 mg TID for Adderall IR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Adderall XR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (15 mg qAM for Adderall XR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Medication Event Monitoring System (MEMS®) Regimen Adherence
2.5 percentage of participants adherent
34.4 percentage of participants adherent

PRIMARY outcome

Timeframe: The MEMS information was noted at clinic visit 3, 4, 5, 7, 8, and 9 (over 8 weeks)

Time adherence (MEMSt) is the percentage of doses taken as prescribed within a specified time period. Adherence was measured as ≥ 80% of doses taken at the correct time. The number below is the percentage of subjects who were adherent.

Outcome measures

Outcome measures
Measure
Adderall IR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (5 mg TID for Adderall IR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Adderall XR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (15 mg qAM for Adderall XR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Medication Event Monitoring System (MEMS®) Time Adherence
4.5 percentage of participants adherent
43.7 percentage of participants adherent

SECONDARY outcome

Timeframe: At clinic visit 3, 4, 5, 7, 8, and 9 (over 8 weeks)

Study staff counted unused medication at each weekly visit to yield a percentage of prescribed pills that were consumed. For each group, the number given will be the total number of consumed pills divided by total number of pill prescribed.

Outcome measures

Outcome measures
Measure
Adderall IR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (5 mg TID for Adderall IR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Adderall XR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (15 mg qAM for Adderall XR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Pill Count
90.4 percentage of pills consumed
96.9 percentage of pills consumed

SECONDARY outcome

Timeframe: At clinic visit 3, 4, 5, 7, 8, and 9 (over 8 weeks)

Self-reported adherence was ascertained via retrospective self-report of daily regimen adherence. Participants were considered adherent for Adderall IR (Methamphetamine salts) if they took the first does in the morning within 30 minutes of waking, and then each subsequent dose in 5-hour intervals (within 30 minutes). For Adderall XR (Methamphetamine salts), participants were considered adherent if they took the single daily dose in the morning within 30 minutes of waking. The number given below represents the total number of self-reported adherent participants divided by the total number of participants per group, times 100 (to obtain percentage).

Outcome measures

Outcome measures
Measure
Adderall IR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (5 mg TID for Adderall IR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Adderall XR (Methamphetamine Salts)
n=49 Participants
All participants were initiated at a total daily dose of 15 mg/day (15 mg qAM for Adderall XR (Methamphetamine Salts)). At visits 3 and 4, the total daily dose of MAS was increased by 15 mg/day until an optimal dose or the maximum total daily dose of 45 mg/day was reached. An optimal dose was determined by clinical efficacy (a ≥ 30% reduction in the baseline total ADHD Rating Scale \[ADHD-RS\] scores) and tolerability.
Self Report
92.6 percentage of participants adherent
98.8 percentage of participants adherent

Adverse Events

Extended Release

Serious events: 0 serious events
Other events: 53 other events
Deaths: 0 deaths

Immediate Release

Serious events: 0 serious events
Other events: 53 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Extended Release
n=62 participants at risk
This was a randomized, crossover study in which participants received 3 weeks of treatment with MAS IR (15, 30, or 45 mg TID) and 3 weeks of treatment with MAS XR (15, 30, or 45 mg qAM). The order of the treatments (TID-qAM or qAM-TID) was counterbalanced across participants, with a washout period of ≥ 7 days between epochs.
Immediate Release
n=62 participants at risk
This was a randomized, crossover study in which participants received 3 weeks of treatment with MAS IR (15, 30, or 45 mg TID) and 3 weeks of treatment with MAS XR (15, 30, or 45 mg qAM). The order of the treatments (TID-qAM or qAM-TID) was counterbalanced across participants, with a washout period of ≥ 7 days between epochs.
Vascular disorders
Headache
6.5%
4/62 • Number of events 6
17.7%
11/62 • Number of events 11
General disorders
Insomnia
22.6%
14/62 • Number of events 15
30.6%
19/62 • Number of events 20
General disorders
Loss of Appetite/Anorexia
37.1%
23/62 • Number of events 26
8.1%
5/62 • Number of events 7
Psychiatric disorders
Anxiety
11.3%
7/62 • Number of events 8
6.5%
4/62 • Number of events 6
Musculoskeletal and connective tissue disorders
Trismus
1.6%
1/62 • Number of events 1
3.2%
2/62 • Number of events 2
Psychiatric disorders
Feeling Speedy or Wired or Jittery
9.7%
6/62 • Number of events 6
6.5%
4/62 • Number of events 4
Gastrointestinal disorders
Nausea
0.00%
0/62
3.2%
2/62 • Number of events 2
General disorders
Dry Mouth
22.6%
14/62 • Number of events 15
16.1%
10/62 • Number of events 10

Additional Information

Dr. Lenard Adler

NYU School of Medicine

Phone: (212) 263-3580

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place