Cannabidivarin (CBDV) vs. Placebo in Children With Autism Spectrum Disorder (ASD)
- Conditions
- Autism Spectrum Disorder
- Interventions
- Drug: Matched Placebo
- Registration Number
- NCT03202303
- Lead Sponsor
- Montefiore Medical Center
- Brief Summary
This trial aims to study the efficacy and safety of cannabidivarin (CBDV) in children with ASD.
- Detailed Description
There is a clear unmet need for new therapeutics to treat irritability in children with ASD that do not have the metabolic and weight adverse event profiles of the currently approved treatments. Cannabidivarin (CBDV) is a nonpsychoactive phytocannabinoid and a safe variant of Cannabidiol (CBD). It has no appreciable tetrahydrocannabinol (THC) \[less than 0.01%\], has been shown to have no impact on weight or metabolism, and improves both social and cognitive functioning in animal models of idiopathic and syndromal autism (Fragile X, Rett Syndrome, Angelman Syndrome). The CDC currently estimates 1 in 59 children have ASD. ASD is characterized by deficits in social communication, irritability, repetitive behaviors, impulsivity, temper tantrums, and high caregiver burden. Currently, the only FDA-approved medications for symptoms of ASD are aripiprazole and risperidone, both of which are indicated for irritability in pediatric ASD. These medications are effective but are associated with considerable side effects with long term treatment in this chronic developmental disorder, including weight gain, metabolic syndrome and the risk of type 2 diabetes, prolactin elevation and growth of breast tissue, extrapyramidal symptoms and the risk of tardive dyskinesia. The anticonvulsant divalproex sodium (valproate/VPA) also significantly reduces irritability and repetitive behaviors in individuals with ASD. Although VPA is efficacious for pediatric epilepsy and some symptoms of ASD, it also has significant side effects, including weight gain, sedation and nausea. CBDV, like VPA, is effective in the treatment of pediatric epilepsy, and ASD mouse models demonstrate potential mechanisms for treatment with CBDV, including potential therapeutic effects on repetitive behaviors, irritability, sociability, and quality of life, and the capacity to reduce inflammation. This study aims to examine the efficacy and safety of cannabidivarin (CBDV) with a primary aim of studying its effect on irritability in children with ASD.
STUDY DESIGN: This is a 12-week randomized, double-blind study of CBDV vs. placebo in 100 child and adolescent subjects aged 5 to 18 years with a diagnosis of ASD.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 100
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Cannabidivarin (CBDV) Cannabidivarin Weight-based dosing of 10 mg/kg/day of CBDV for 12 weeks Matched Placebo Matched Placebo Weight-based dosing of 10 mg/kg/day of placebo for 12 weeks
- Primary Outcome Measures
Name Time Method Aberrant Behavior Checklist-Irritability (ABC-I) Subscale Change from Baseline to Week 12 (Change over 12 weeks) Change in aberrant behavior from baseline will be assessed using the irritability subscale of the ABC. The ABC is an informative rating instrument that was empirically derived by principal component analysis to measure behavior in those with developmental disability and autism spectrum disorder (ASD). The ABC-I will be completed by any adult who knows the patient well, such as a parent/caregiver. The ABC-I subscale consists of 15 items that address the presence of aggression, tantrums, and/or self-injury. Scores for each item on the subscale range from 0 (no problem at all) to 3 (problem is severe in degree), yielding an overall possible score for the subscale from 0-45, such that higher scores are indicative of increased severity of irritability. Scores will be summarized by study arm using basic descriptive statistics.
- Secondary Outcome Measures
Name Time Method Repetitive Behavior Scale-Revised (RBS-R) Change in RBS-R from Baseline to Week 12 (Change over 12 weeks) Change in repetitive behavior from baseline will be assessed using the RBS-R, a 43-item self-report instrument that is used to measure the breadth of repetitive behaviors specific to autism spectrum disorder (ASD) symptomatology. The 43 items encompass 6 behavioral subscales including: Stereotypic (6 items); Self-injurious (8 items); Compulsive (8 items); Ritualistic (6 items); Sameness (11 items); and Restricted Behavior (4 items). A list of behaviors will be presented and the parent will be asked to choose a score that best describes how much of a problem the behavior has been over the last month. Behaviors are rated on a 4-point scale: 0 (behavior does not occur), 1 (behavior occurs and is a mild problem), 2 (behavior occurs and is a moderate problem) and 3 (behavior occurs and is a severe problem). Higher scores reflect increased severity of repetitive behavior for that scale. Scores for each of the 6 subscales will be summarized by arm using basic descriptive statistics.
Montefiore Einstein Rigidity Scale-Revised (MERS-R) Change in MERS-R from Baseline to Week 12 (Change over 12 weeks) Change in rigidity from baseline will be assessed using the MERS-R. MERS-R is designed to assess three domains of rigid behavior in children (and adults) with ASD: Behavioral Rigidity (e.g., insistence on sameness, things must be done his/her way, etc.); Cognitive Rigidity (e.g., special interests, inflexible adherence to rules, etc.); and Protest (in response to deviation from rigidity; e.g., verbal objection, tantrum, physical aggression). MERS-R is a clinician-rated scale and will only be completed only for subjects who display rigid behaviors at baseline, and study visits during week 4, week 8, and week 12. The MERS-R consists of 43 items. Each item is scored based on a 4-point scale ranging from 0 (no problem) to 3 (severe problem) for rigid behaviors displayed over the past month, yielding an overall MERS-R score of 0-129. Higher scores are associated with more severe rigidity. Scores will be summarized by study arm using basic descriptive statistics.
Aberrant Behavior Checklist-Social Withdrawal (ABC-SW) Subscale Change in ABC-SW from Baseline to Week 12 (Change over 12 weeks) Change in aberrant behavior from baseline will also be evaluated using the Social Withdrawal subscale of the Aberrant Behavior Checklist (ABC). The ABC is an informant rating instrument that measures behavior in individuals with developmental disability and ASD. The ABC-SW scale measures behavior using a 4-point severity scale, ranging from 0-3, where parents rate aberrant behaviors as 0 = no problem at all, 1 = behavior is a problem but in a slight degree, 2 = problem is moderately serious, and 3 = problem is severe in degree, such that higher scores are associated with increased severity of social withdrawal, for an overall possible score of 0-48. Scores will be summarized by study arm using basic descriptive statistics.
Pediatric Quality of Life Inventory (PedsQL) Family Impact Module Change in PedsQL from Baseline to Week 12 (Change over 12 weeks) Change in quality of life is assessed using the PedsQL family impact module, a 36-item self-report caregiver form used to measure caregiver functioning. PedsQL encompasses 6 scales: Physical Functioning (6 items), Emotional Functioning (5 items), Social Functioning (4 items), Cognitive Functioning (5 items), Communication (3 items), Worry (5 items) and 2 scales measuring caregiver-reported family functioning: Daily Activities (3 items) and Family Relationships (5 items). Each item is scored using a 5-point scale ranging from 0 (never a problem) to 4 (always a problem). Items are then reverse-scored and transformed to a 0-100 scale (0 = 100, 1 = 75, 2 = 50, 3 = 25, 4 = 0), such that higher scores indicate better functioning (less negative impact). Scale Scores are computed as the sum of the items divided by the number of items answered (to account for missing data). If \>50% of the items in the scale are missing, a scale score is not computed. Scores will be summarized by study arm.
Vineland Adaptive Behavior Scale, Third Edition (VABS-3) Change in VABS-3 from Baseline to Week 12 (Change over 12 weeks) Change in adaptive behavior from baseline will be assessed using the VABS-3. The VABS-3 is an instrument that measures adaptive behavior across 5 domains: communication, daily living skills, socialization, motor skills, and maladaptive behavior of individuals with developmental disabilities. The Survey Interview Form (semi-structured interview) will be administered to a participant's reliable caregiver in this study, during which the interviewer will ask the caregiver open ended questions relating to the subject's activities and behavior. Scoring involves assigning points (0, 1, or 2) to each item based on the responses to the questions. These scores are then compared to normative data to determine the individual's standing relative to peers. Higher scores are generally indicative of better adaptive behavior. Scores will be summarized by study arm using basic descriptive statistics.
Clinical Global Impressions - Improvement (CGI-I) Change in CGI-I from Baseline to Week 12 (Change over 12 weeks) The degree of change of in condition from baseline will be assessed using the CGI-I scale. The CGI-I is a clinician-rated global measure of improvement scale used to assess the degree of symptom change in a patient relative to baseline condition. It consists of a 7-point scale as follows: 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse, such that lower scores are indicative of increased symptom improvement. Scores will be summarized by study arm using basic descriptive statistics.
Trial Locations
- Locations (2)
New York University (NYU) Langone
🇺🇸New York, New York, United States
Montefiore Medical Center
🇺🇸The Bronx, New York, United States
New York University (NYU) Langone🇺🇸New York, New York, United States