Trial Outcomes & Findings for Acamprosate in Youth With Fragile X Syndrome (NCT NCT01300923)

NCT ID: NCT01300923

Last Updated: 2019-07-30

Results Overview

The Clinical Global Impression - Severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis. Considering total clinical experience, a patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

14 participants

Primary outcome timeframe

Week 10

Results posted on

2019-07-30

Participant Flow

The psychophysiological measures proved non-feasible as subjects could not tolerate the procedures. The paradigms were tried on two subjects in the Autism Spectrum Disorder arm; however, the data that was collected was not usable. Subsequently, neurobiological characterization was halted.

Participant milestones

Participant milestones
Measure
Acamprosate
The maximum dose of acamprosate to be used in this study is 1998 mg per day for those subjects weighing greater than 60kg and 1332 mg per day for those less weighing less than 60kg. Acamprosate
Autism Spectrum Disorder (ADS)
This baseline comparison group will participated in only and biomarker portion of subject characterization.
Overall Study
STARTED
12
2
Overall Study
COMPLETED
12
0
Overall Study
NOT COMPLETED
0
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Acamprosate
The maximum dose of acamprosate to be used in this study is 1998 mg per day for those subjects weighing greater than 60kg and 1332 mg per day for those less weighing less than 60kg. Acamprosate
Autism Spectrum Disorder (ADS)
This baseline comparison group will participated in only and biomarker portion of subject characterization.
Overall Study
Physician Decision
0
2

Baseline Characteristics

Acamprosate in Youth With Fragile X Syndrome

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day)
Age, Categorical
<=18 years
12 Participants
n=99 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=99 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
Age, Continuous
11.9 years
n=99 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
Sex: Female, Male
Male
10 Participants
n=99 Participants
Region of Enrollment
United States
12 participants
n=99 Participants
Aberrant Behavior Checklist
ABC Irritability
9.9 units on a scale
STANDARD_DEVIATION 7.8 • n=99 Participants
Aberrant Behavior Checklist
ABC Social Withdrawal
8.8 units on a scale
STANDARD_DEVIATION 5.8 • n=99 Participants
Aberrant Behavior Checklist
ABC Stereotypy
6.8 units on a scale
STANDARD_DEVIATION 6.8 • n=99 Participants
Aberrant Behavior Checklist
ABC Hyperactivity
16.8 units on a scale
STANDARD_DEVIATION 9.1 • n=99 Participants
Aberrant Behavior Checklist
ABC Inappropriate Speech
5.2 units on a scale
STANDARD_DEVIATION 3.5 • n=99 Participants
Aberrant Behavior Checklist
ABC Social Avoidance
3.3 units on a scale
STANDARD_DEVIATION 2.6 • n=99 Participants
Clinical Global Impression -Severity
4.25 units on a scale
STANDARD_DEVIATION 0.45 • n=99 Participants
Children's Yale-Brown Obsessive Compulsive Scale Modified for PDD
11.1 units on a scale
STANDARD_DEVIATION 2.6 • n=99 Participants
Social Responsiveness Scale
91.3 units on a scale
STANDARD_DEVIATION 27.4 • n=99 Participants
ADHD Rating Scale 4th Edition
23.6 units on a scale
STANDARD_DEVIATION 10.6 • n=99 Participants
Peabody Picture Vocabulary Test
85.2 units on a scale
STANDARD_DEVIATION 32.0 • n=99 Participants
Vineland Adaptive Behavior Scales-II (VABS-II) Communication Domain
Communication Domain
63.4 units on a scale
STANDARD_DEVIATION 10.0 • n=99 Participants
Vineland Adaptive Behavior Scales-II (VABS-II) Communication Domain
Expressive Communication Domain
69.8 units on a scale
STANDARD_DEVIATION 23.0 • n=99 Participants
Brain-derived neurotropic factor
790.4 pg/mL
STANDARD_DEVIATION 1.3050 • n=99 Participants

PRIMARY outcome

Timeframe: Week 10

The Clinical Global Impression - Severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis. Considering total clinical experience, a patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
Clinical Global Impression- Severity Scale (CGI-S)
7.0 units on a scale
Standard Deviation 8.9

SECONDARY outcome

Timeframe: Week 10

The Aberrant Behavior Checklist (ABC) is a 58-item rating scale used to assess maladaptive behaviors across five original subscales: Irritability (15 items from 0-45), Social Withdrawal (16 items from 0-48), Stereotypy (7 items from 0-21), Hyperactivity (16 items from 0-48), Inappropriate Speech (4 items from 0-12). Additionally, Social Avoidance, a newly developed four-item subscale (from 0-12) of the ABC that captures core social avoidance aspects of Fragile X Syndrome is reported. All items on the ABC are rated from 0 (not at all a problem) to 3 (the problem is severe in degree). Higher scores indicate greater maladaptive behaviors. Differences between Baseline and Week 10 are used as an indicator of change.

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
The Aberrant Behavior Checklist (ABC)
ABC Irritability
7.0 units on a scale
Standard Deviation 8.9
The Aberrant Behavior Checklist (ABC)
ABC Social Withdrawal
4.1 units on a scale
Standard Deviation 6.5
The Aberrant Behavior Checklist (ABC)
ABC Stereotypy
6.0 units on a scale
Standard Deviation 6.3
The Aberrant Behavior Checklist (ABC)
ABC Hyperactivity
11.0 units on a scale
Standard Deviation 8.6
The Aberrant Behavior Checklist (ABC)
ABC Inappropriate Speech
4.8 units on a scale
Standard Deviation 3.4
The Aberrant Behavior Checklist (ABC)
ABC Social Avoidance
1.6 units on a scale
Standard Deviation 2.7

SECONDARY outcome

Timeframe: Week 10

The 65-item SRS is a standardized measure of the core symptoms of autism. Each item is scored on a 4-point Likert scale. The score of each individual item is summed to create a total raw score. A total scores results are as follows: 0-62: Within normal limits 63-79: Mild range of impairment 80-108: Moderate range of impairment 109-149: Severe range of impairment

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
Social Responsiveness Scale
76.4 units on a scale
Standard Deviation 26.8

SECONDARY outcome

Timeframe: Week 10

The Children's Yale-Brown Obsessive Compulsive Scales-Modified (CY-BOCS) is a 5-item, semi-structured clinician rating scale modified designed to rate the current severity of repetitive behavior in children and adolescents with PDD. Once the current repetitive behaviors are identified, they are separately rated on 5 items: Time Spent, Interference, Distress, Resistance, and Control. Each of these items is scored on a 5-point scale form 0 (least symptomatic) to 4 (most symptomatic). The CY-BOCS yields a Total Score from 0 to 20 and is sensitive to change.

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
Children's Yale-Brown Obsessive Compulsive Scale Modified for PDD
9.8 units on a scale
Standard Deviation 4.1

SECONDARY outcome

Timeframe: Week 10

The ADHD Rating Scale is an 18-item scale directly derived from DSM-IV criteria for Attention Deficit Hyperactivity Disorder. The ADHD Rating Scale-IV is completed by the parent and scored by a clinician. The scale consists of 2 subscales: inattention (9 items) and hyperactivity-impulsivity (9 items). If 3 or more items are skipped, the clinician should use extreme caution in interpreting the scale. The total score can range from 0 to 54, with a higher score indicating greater severity.

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
ADHD Rating Scale 4th Edition
16.7 units on a scale
Standard Deviation 8.0

SECONDARY outcome

Timeframe: Week 10

The VABS-II is a semi-structured interview designed to assess adaptive functioning in communication, daily living, socialization and motor skills. Recognizing that language is a major area of impairment in the study population, the Communication Domain (99 Items from 0-198), in particular the Expressive Subdomain (54 Items from 0-108) are of interest in this study. Items arranged in a developmental sequence are rated on a 3-point scale. Each item is scored from 0 (never performs the behavior) to 3 (usually performs the behavior independently). Higher scores indicate higher adaptive functioning. Differences between Baseline and Week 10 are used as an indicator of change.

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
Vineland Adaptive Behavior Scales-II (VABS-II) Communication Domain
Communication Domain
66.6 units on a scale
Standard Deviation 11.2
Vineland Adaptive Behavior Scales-II (VABS-II) Communication Domain
Expressive Communication
78.9 units on a scale
Standard Deviation 21.2

SECONDARY outcome

Timeframe: Week 10

The Peabody Picture Vocabulary Test is one of the most commonly used assessment tests that measure verbal ability in standard American English vocabulary. This test has been nationally standardized using examinees from various age groups, from children to adults. Thus, the raw scores are equated to mental age, using the norms obtained from standardization. The total standard scores range from 40 (worse receptive vocabulary) to 160 (better receptive vocabulary). The scores can also be converted to percentile rank.

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=12 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
Peabody Picture Vocabulary
83.3 units on a scale
Standard Deviation 32.0

SECONDARY outcome

Timeframe: Screen and Week 10

BDNF is a protein that supports the survival of existing neurons and growth and differentiation of new neurons and synapses.

Outcome measures

Outcome measures
Measure
Acamprosate Treatment Group
n=10 Participants
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day).
Brain-derived Neurotrophic Factor (BDNF)
1,007.6 pg/mL
Standard Deviation 1,493.2

Adverse Events

Acamprosate

Serious events: 0 serious events
Other events: 9 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Acamprosate
n=12 participants at risk
The maximum dose of acamprosate to be used in this study is 1998 mg per day for those subjects weighing greater than 60kg and 1332 mg per day for those less weighing less than 60kg.
Psychiatric disorders
Irritability
33.3%
4/12 • Number of events 4 • Ten Weeks
Psychiatric disorders
Increased repetitive behavior
16.7%
2/12 • Number of events 2 • Ten Weeks
Gastrointestinal disorders
Diarrhea
8.3%
1/12 • Number of events 1 • Ten Weeks
Gastrointestinal disorders
mild constipation
8.3%
1/12 • Number of events 1 • Ten Weeks
Psychiatric disorders
Increased anxiety
8.3%
1/12 • Number of events 1 • Ten Weeks
Psychiatric disorders
Insomnia
8.3%
1/12 • Number of events 1 • Ten Weeks
Psychiatric disorders
Nightmares
8.3%
1/12 • Number of events 1 • Ten Weeks
Infections and infestations
Rhinitis
8.3%
1/12 • Number of events 1 • Ten Weeks
Renal and urinary disorders
Urinary Urgency
8.3%
1/12 • Number of events 1 • Ten Weeks

Additional Information

Craig Erickson

Cincinnati Childrens Hospital

Phone: 5136366265

Results disclosure agreements

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