Trial Outcomes & Findings for Low-Dose Ketamine in Children With ADNP Syndrome (NCT NCT04388774)
NCT ID: NCT04388774
Last Updated: 2023-07-07
Results Overview
Number of Participants with an adverse event as defined by the Systematic Longitudinal Assessment of Adverse Events (SLAES) which is a comprehensive form that assesses medical and behavioral conditions that were present at screening and/or baseline. Conditions are considered treatment emergent if their severity increased significantly after the participant had taken at least one dose of the study treatment. Treatment emergent adverse events will be tracked considered in the adverse event safety analysis. Severity of adverse events are categorized as mild, moderate, severe, life-threatening, or resulting in death and the treating physician indicates if the adverse event was related or unrelated to study drug.
COMPLETED
PHASE1/PHASE2
10 participants
Week 4
2023-07-07
Participant Flow
Ten participants were screened, and all met criteria for inclusion and were enrolled between August 2020 and May 2021.
Participant milestones
| Measure |
Ketamine
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
|---|---|
|
Overall Study
STARTED
|
10
|
|
Overall Study
COMPLETED
|
10
|
|
Overall Study
NOT COMPLETED
|
0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Low-Dose Ketamine in Children With ADNP Syndrome
Baseline characteristics by cohort
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
|---|---|
|
Age, Continuous
|
9.50 years
STANDARD_DEVIATION 2.30 • n=99 Participants
|
|
Sex: Female, Male
Female
|
3 Participants
n=99 Participants
|
|
Sex: Female, Male
Male
|
7 Participants
n=99 Participants
|
|
Race/Ethnicity, Customized
Hispanic/Latino
|
2 Participants
n=99 Participants
|
|
Race/Ethnicity, Customized
White
|
8 Participants
n=99 Participants
|
|
Developmental quotient
VDQ - verbal developmental quotient
|
26.71 quotient
STANDARD_DEVIATION 15.33 • n=99 Participants
|
|
Developmental quotient
NVDQ - nonverbal developmental quotient
|
31.28 quotient
STANDARD_DEVIATION 16.13 • n=99 Participants
|
|
Developmental quotient
FSDQ - full scale developmental quotient
|
28.81 quotient
STANDARD_DEVIATION 15.42 • n=99 Participants
|
|
Number of Participants with ASD
|
4 Participants
n=99 Participants
|
|
Number of Participants with ADHD
|
7 Participants
n=99 Participants
|
|
Genetic mutation
Frameshift
|
6 Participants
n=99 Participants
|
|
Genetic mutation
Nonsense
|
4 Participants
n=99 Participants
|
PRIMARY outcome
Timeframe: Week 4Number of Participants with an adverse event as defined by the Systematic Longitudinal Assessment of Adverse Events (SLAES) which is a comprehensive form that assesses medical and behavioral conditions that were present at screening and/or baseline. Conditions are considered treatment emergent if their severity increased significantly after the participant had taken at least one dose of the study treatment. Treatment emergent adverse events will be tracked considered in the adverse event safety analysis. Severity of adverse events are categorized as mild, moderate, severe, life-threatening, or resulting in death and the treating physician indicates if the adverse event was related or unrelated to study drug.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Number of Participants With an Adverse Event
|
9 Participants
|
—
|
SECONDARY outcome
Timeframe: Baseline, Week 1Population: Each participant had one caregiver provide rated assessments.
Changes in scale at week 1 compared to baseline. Aberrant Behavior Checklist is a behavior rating scale for the assessment of treatment effects. Each item is scored as 0 (never a problem), 1 (slight problem), 2 (moderately serious problem), or 3 (severe problem). Subscales from 0-45 for Irritability; 0-48 for Social Withdrawal and Hyperactivity; from 0-21 for Stereotypy; and 0-12 for In Speech , with total scale from 0 to 48, with higher score indicating worse health outcomes.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
n=10 Participants
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Aberrant Behavior Checklist
Irritability
|
20.5 score on a scale
Standard Deviation 13.33
|
10.9 score on a scale
Standard Deviation 10.6
|
|
Aberrant Behavior Checklist
Social withdrawal
|
9.9 score on a scale
Standard Deviation 8.96
|
4.2 score on a scale
Standard Deviation 4.96
|
|
Aberrant Behavior Checklist
Motor stereotypies
|
7.8 score on a scale
Standard Deviation 5.31
|
4.5 score on a scale
Standard Deviation 3.66
|
|
Aberrant Behavior Checklist
Hyperactivity
|
24.5 score on a scale
Standard Deviation 14.66
|
16.2 score on a scale
Standard Deviation 13.35
|
|
Aberrant Behavior Checklist
Inappropriate speech
|
3.6 score on a scale
Standard Deviation 2.88
|
3.3 score on a scale
Standard Deviation 2.21
|
SECONDARY outcome
Timeframe: Baseline and Week 1The ADAMS is a parent/caregiver-completed measure and consists of 28 items, grouped into five subscales (Manic/Hyperactive Behavior, Depressed Mood, Social Avoidance, General Anxiety, Obsessive Behavior), and scored on a four-point Likert scale that combines frequency and severity ratings from 0-3. Subscales range - Hyperactivity 0-15; Depressed 0-21; Social Avoidance 0-21; General anxiety 0-21; OCD 0-9. Scores are not summed. Higher score indicates poorer health outcomes.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
n=10 Participants
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Anxiety, Depression and Mood Scales (ADAMS)
Hyperactivity
|
10.1 score on a scale
Standard Deviation 4.23
|
6.7 score on a scale
Standard Deviation 3.5
|
|
Anxiety, Depression and Mood Scales (ADAMS)
Depressed
|
2.6 score on a scale
Standard Deviation 3.31
|
2.1 score on a scale
Standard Deviation 2.69
|
|
Anxiety, Depression and Mood Scales (ADAMS)
Social avoidance
|
6.1 score on a scale
Standard Deviation 4.23
|
3.5 score on a scale
Standard Deviation 3.47
|
|
Anxiety, Depression and Mood Scales (ADAMS)
General anxiety
|
6.3 score on a scale
Standard Deviation 5.96
|
4.3 score on a scale
Standard Deviation 4.74
|
|
Anxiety, Depression and Mood Scales (ADAMS)
Obsessive/compulsive
|
2.5 score on a scale
Standard Deviation 2.01
|
1.6 score on a scale
Standard Deviation 1.51
|
SECONDARY outcome
Timeframe: Baseline, Week 1Change in repetitive behaviors at weeks 1 compared to baseline. RBS-R subscales - Stereo 0-18; Self injury 0-24; Compulsive 0-24; Ritualistic 0-18; Sameness 0-33; Restricted 0-12. Total scale range from 0 to 126 with higher score indicating worse health outcomes.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
n=10 Participants
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Repetitive Behavior Scale-Revised (RBS-R)
Stereotyped
|
6.6 score on a scale
Standard Deviation 3.31
|
5.1 score on a scale
Standard Deviation 4.93
|
|
Repetitive Behavior Scale-Revised (RBS-R)
Self-injury
|
5.9 score on a scale
Standard Deviation 4.79
|
4.2 score on a scale
Standard Deviation 3.49
|
|
Repetitive Behavior Scale-Revised (RBS-R)
Compulsive
|
3.7 score on a scale
Standard Deviation 2.75
|
2.2 score on a scale
Standard Deviation 1.87
|
|
Repetitive Behavior Scale-Revised (RBS-R)
Ritualistic
|
2.9 score on a scale
Standard Deviation 3.63
|
2.9 score on a scale
Standard Deviation 2.38
|
|
Repetitive Behavior Scale-Revised (RBS-R)
Sameness
|
5.6 score on a scale
Standard Deviation 6.33
|
4.3 score on a scale
Standard Deviation 5.46
|
|
Repetitive Behavior Scale-Revised (RBS-R)
Restricted
|
3.9 score on a scale
Standard Deviation 3.14
|
3.6 score on a scale
Standard Deviation 2.37
|
|
Repetitive Behavior Scale-Revised (RBS-R)
Overall
|
28.6 score on a scale
Standard Deviation 17.56
|
22.3 score on a scale
Standard Deviation 14.28
|
SECONDARY outcome
Timeframe: Baseline, Week 2, and Week 4Changes in scale at weeks 2, and 4 compared to baseline. Clinical Global impressions - Improvement Scale is anchored to symptoms of ADNP syndrome for the assessment of treatment effects. CGI-I total score from 1 to 7 point scale, with higher score indicating worse health outcomes.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Clinical Global Impressions - Improvement Scale (CGI-I)
Baseline
|
0 score on a scale
Standard Deviation 0
|
—
|
|
Clinical Global Impressions - Improvement Scale (CGI-I)
Week 2
|
1.5 score on a scale
Standard Deviation 0.53
|
—
|
|
Clinical Global Impressions - Improvement Scale (CGI-I)
Week 4
|
1.0 score on a scale
Standard Deviation 0.52
|
—
|
SECONDARY outcome
Timeframe: Baseline, Week 1Change in sleep habits at week 1 compared to baseline. Full scale from 0 to 110, with higher score indicating worse health outcomes.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
n=10 Participants
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Childrens Sleep Habits Questionnaire
|
2.83 units on a scale
Standard Deviation 0.75
|
2.93 units on a scale
Standard Deviation 0.82
|
SECONDARY outcome
Timeframe: Baseline, Week 1, Week 2, and Week 4Expressive and receptive language assessed by Peabody Picture Vocabulary Test and Expressive Vocabulary Test at Day 1, Weeks 1, 2, and 4. Full scale from 40 to 160, with higher score indicating better health outcomes.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Peabody Picture Vocabulary Test and Expressive Vocabulary Test
Baseline, Day 1
|
50.9 score on a scale
Standard Deviation 13.40
|
—
|
|
Peabody Picture Vocabulary Test and Expressive Vocabulary Test
Week 1
|
52.8 score on a scale
Standard Deviation 17.38
|
—
|
|
Peabody Picture Vocabulary Test and Expressive Vocabulary Test
Week 2
|
51.5 score on a scale
Standard Deviation 13.87
|
—
|
|
Peabody Picture Vocabulary Test and Expressive Vocabulary Test
Week 4
|
50.9 score on a scale
Standard Deviation 15.29
|
—
|
SECONDARY outcome
Timeframe: Baseline, Day 1, Week 1Population: Not every trial was valid. Eye tracking data were successfully collected from nine participants for the Joint Attention task, but only four participants had \>25% valid trials at all three time points and were included in analysis.
Change at Day 1 and Week 1 as compared to baseline using computerized eye tracking to record where the subject is looking during an activity in which the subject will see a video of a person with two objects, turning her head towards one of the objects, the target. Mean proportion of trials in which participants made saccades to the target before the distractor.
Outcome measures
| Measure |
Ketamine
n=48 Trials
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Proportion of Target-First Trials Saccades
Baseline
|
0.53 proportion of target-first saccades
Standard Deviation 0.14
|
—
|
|
Proportion of Target-First Trials Saccades
Day 1
|
0.75 proportion of target-first saccades
Standard Deviation 0.17
|
—
|
|
Proportion of Target-First Trials Saccades
Week 1
|
0.70 proportion of target-first saccades
Standard Deviation 0.14
|
—
|
SECONDARY outcome
Timeframe: Baseline, Day 1, Week 1Population: Eye tracking data were successfully collected from nine participants for the Joint Attention task, but only four participants had \>25% valid trials at all three time points and were included in analysis.
Change at week 1, week 2, and week 4 as compared to baseline using computerized eye tracking to record where the subject is looking during an activity in which the subject will see different social and non-social stimuli. Latency to first saccade to the target
Outcome measures
| Measure |
Ketamine
n=4 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Latency to First Saccade
Baseline
|
2319.38 ms
Standard Deviation 1202.34
|
—
|
|
Latency to First Saccade
Day 1
|
2089.96 ms
Standard Deviation 754.70
|
—
|
|
Latency to First Saccade
Week 1
|
1674.18 ms
Standard Deviation 301.93
|
—
|
SECONDARY outcome
Timeframe: Baseline, Day 1, Week 1Population: Eye tracking data were successfully collected from nine participants for the Joint Attention task, but only four participants had \>25% valid trials at all three time points and were included in analysis.
Change at Day 1 and Week 1 as compared to baseline using computerized eye tracking to record where the subject is looking during an activity in which the subject will see different social and non-social stimuli. Proportion of time participants spent dwelling on the target versus distractor.
Outcome measures
| Measure |
Ketamine
n=4 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Proportion of Target-Dwelling
Week 1
|
0.66 proportion of time
Standard Deviation 0.11
|
—
|
|
Proportion of Target-Dwelling
Baseline
|
0.51 proportion of time
Standard Deviation 0.19
|
—
|
|
Proportion of Target-Dwelling
Day 1
|
0.59 proportion of time
Standard Deviation 0.13
|
—
|
SECONDARY outcome
Timeframe: Baseline, Week 1, Week 2, and Week 4Population: participants with fewer than five wavelets at any time point were excluded
Electroencephalographic recordings to measure Auditory Event Related Potentials at baseline, week 1, week 2, and week 4. In separate blocks, participants heard a 500-ms click at either a stimulation rate of 40 or 20 Hz. Click trains were presented 150 times each, with an intertrial interval of 50 ms, at approximately 60 db. Higher number indicates higher amplitude neural response to auditory stimuli.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Electrophysiology Recording
40-Hz Baseline
|
0.19 ms
Standard Deviation 0.03
|
—
|
|
Electrophysiology Recording
40-Hz Week1
|
0.26 ms
Standard Deviation 0.09
|
—
|
|
Electrophysiology Recording
20-Hz Baseline
|
0.18 ms
Standard Deviation 0.06
|
—
|
|
Electrophysiology Recording
20-Hz Week 1
|
0.15 ms
Standard Deviation 0.05
|
—
|
|
Electrophysiology Recording
20-Hz Week 2
|
0.18 ms
Standard Deviation 0.06
|
—
|
|
Electrophysiology Recording
20-Hz Week 4
|
0.19 ms
Standard Deviation 0.11
|
—
|
|
Electrophysiology Recording
40-Hz Week 2
|
0.18 ms
Standard Deviation 0.06
|
—
|
|
Electrophysiology Recording
40-Hz Week 4
|
0.20 ms
Standard Deviation 0.06
|
—
|
SECONDARY outcome
Timeframe: Baseline and Week 4Changes in scale at week 4 compared to baseline. Vineland Adaptive Behavior Scales measures adaptive functioning. Higher score indicating better health outcomes. Domain scores are standard scores - population mean 100 standard deviation 15. an overall composite score, it consists of three subscales: (a) communication (receptive, expressive, written), (b) socialization (interpersonal relationships, play and leisure, coping skills), and (c) daily living (person, domestic, community).
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
n=10 Participants
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Vineland Adaptive Behavior Scales
Abc
|
42.7 score on a scale
Standard Deviation 13.9
|
44.0 score on a scale
Standard Deviation 15.19
|
|
Vineland Adaptive Behavior Scales
Comm
|
32.6 score on a scale
Standard Deviation 14.73
|
33.4 score on a scale
Standard Deviation 15.53
|
|
Vineland Adaptive Behavior Scales
Daily Living
|
48.5 score on a scale
Standard Deviation 14.45
|
49.2 score on a scale
Standard Deviation 16.14
|
|
Vineland Adaptive Behavior Scales
Social
|
44.5 score on a scale
Standard Deviation 15.62
|
46.8 score on a scale
Standard Deviation 16.90
|
|
Vineland Adaptive Behavior Scales
Motor
|
51.5 score on a scale
Standard Deviation 8.73
|
49.83 score on a scale
Standard Deviation 4.58
|
SECONDARY outcome
Timeframe: Baseline and Week 1Caregiver Strain Questionnaire (CGSQ) is a 13 question tool, with a 5-point Likert scale ranging from Not at all (0) to Very much (4). Domains (Objective strain, Subjective externalized strain, Subjective internalized strain) are averaged scores, range from 0-4. Total score (Global score) is a sum of the three subdomains. Full scale range 0-12, higher score indicates more severe strain.
Outcome measures
| Measure |
Ketamine
n=10 Participants
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
Caregiver Rated Assessment at 1 Week
n=10 Participants
Caregiver rated assessments at 1 week
|
|---|---|---|
|
Caregiver Strain Questionnaire (CGSQ)
Global score
|
8.27 score on a scale
Standard Deviation 3.08
|
6.77 score on a scale
Standard Deviation 2.32
|
|
Caregiver Strain Questionnaire (CGSQ)
Objective strain
|
2.79 score on a scale
Standard Deviation 1.11
|
2.45 score on a scale
Standard Deviation 0.99
|
|
Caregiver Strain Questionnaire (CGSQ)
Subjective externalized strain
|
2.18 score on a scale
Standard Deviation 1.11
|
1.62 score on a scale
Standard Deviation 0.69
|
|
Caregiver Strain Questionnaire (CGSQ)
Subjective internalized strain
|
3.3 score on a scale
Standard Deviation 1.15
|
2.7 score on a scale
Standard Deviation 0.97
|
Adverse Events
Ketamine
Serious adverse events
Adverse event data not reported
Other adverse events
| Measure |
Ketamine
n=10 participants at risk
Single-dose (0.5 mg/kg) infused intravenously over 40 minutes
|
|---|---|
|
Psychiatric disorders
Elated/silly
|
50.0%
5/10 • 4 Weeks
|
|
Psychiatric disorders
Aggression
|
40.0%
4/10 • 4 Weeks
|
|
Nervous system disorders
Fatigue
|
40.0%
4/10 • 4 Weeks
|
|
General disorders
Decreased appetite
|
30.0%
3/10 • 4 Weeks
|
|
Psychiatric disorders
Anxiety
|
30.0%
3/10 • 4 Weeks
|
|
General disorders
Increased appetite
|
20.0%
2/10 • 4 Weeks
|
|
Psychiatric disorders
Restless
|
20.0%
2/10 • 4 Weeks
|
|
General disorders
Increased fluid intake
|
20.0%
2/10 • 4 Weeks
|
|
Gastrointestinal disorders
Nausea/vomiting
|
20.0%
2/10 • 4 Weeks
|
|
Psychiatric disorders
Moody/irritable
|
20.0%
2/10 • 4 Weeks
|
|
General disorders
Dry mouth
|
20.0%
2/10 • 4 Weeks
|
|
Gastrointestinal disorders
Gagging/reflux
|
10.0%
1/10 • 4 Weeks
|
|
Psychiatric disorders
Self-injury
|
10.0%
1/10 • 4 Weeks
|
|
Gastrointestinal disorders
Loose stool
|
10.0%
1/10 • 4 Weeks
|
|
Nervous system disorders
Difficulty falling asleep
|
10.0%
1/10 • 4 Weeks
|
|
Nervous system disorders
Early morning wakening
|
10.0%
1/10 • 4 Weeks
|
|
Musculoskeletal and connective tissue disorders
Limping with possible pain
|
10.0%
1/10 • 4 Weeks
|
|
General disorders
Decreased fluid intake
|
10.0%
1/10 • 4 Weeks
|
|
Psychiatric disorders
Distractibility
|
10.0%
1/10 • 4 Weeks
|
|
Gastrointestinal disorders
Constipation
|
10.0%
1/10 • 4 Weeks
|
|
Psychiatric disorders
Increased frustration
|
10.0%
1/10 • 4 Weeks
|
|
Psychiatric disorders
Oppositional
|
10.0%
1/10 • 4 Weeks
|
|
Infections and infestations
Upper respiratory tract infection
|
10.0%
1/10 • 4 Weeks
|
|
Psychiatric disorders
Agitation
|
10.0%
1/10 • 4 Weeks
|
Additional Information
Dr. Alexander Kolevzon
Icahn School of Medicine at Mount Sinai
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place