Phase IV Long-term Maintenance Study of Aripiprazole in the Treatment of Irritability Associated With Autistic Disorder
- Conditions
- Irritability Associated With Autistic Disorder
- Interventions
- Drug: Placebo
- Registration Number
- NCT01227668
- Lead Sponsor
- Bristol-Myers Squibb
- Brief Summary
The purpose of this study is to determine whether pediatric participants with irritability associated with autistic disorder who have responded to aripiprazole treatment will experience a relapse significantly later when continuing therapy with aripiprazole than will participants who receive placebo
- Detailed Description
Phase 1: Single blind/ Phase 2: Double blind
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 215
- Male or female children or adolescents, 6 to 17 years of age, inclusive, at the time of the baseline visit
- Meets current diagnostic criteria of the Diagnostic and Statistical Manual-of Mental Disorders IV-Text Revised for autistic disorder and displays behaviors such as tantrums, aggression, self-injurious behavior, or a combination of these problems. Diagnosis of autistic disorder will be confirmed by the Autism Diagnostic Interview-Revised.
- Participant or designated guardian or caregiver is able to comprehend and satisfactorily comply with the protocol requirements, in the opinion of the investigator.
- Demonstrates behaviors such as tantrums, aggression, or self-injury or a combination of these problems
- An Aberrant Behavior Checklist Irritability subscale score ≥18 AND a Clinical Global Impressions Severity score ≥4 at the Screening and Baseline Visits.
- Mental age of at least 24 months
Key
- Treatment resistant to neuroleptic medication, based on lack of therapeutic response to 2 different neuroleptics after treatment for at least 3 weeks each.
- Previous treatment with aripiprazole for at least 3 weeks duration at an adequate daily dose, without demonstrating a clinically meaningful response.
- Lifetime diagnosis of bipolar disorder, psychosis, or schizophrenia, or a current diagnosis of major depressive disorder
- Diagnosis of Pervasive Developmental Disorder-Not Otherwise Specified, Asperger's Syndrome, Rett's Syndrome, childhood disintegrative disorder, or Fragile X Syndrome
- History of neuroleptic malignant syndrome
- At significant risk for suicide based on history or routine psychiatric status examination
- A seizure within the past year
- History of severe head trauma or stroke
- History or current evidence of any unstable medical conditions that would expose the patient to undue risk of a significant adverse event or interfere with assessments of safety or efficacy during the course of the trial
- Weight lower than 15 kg
- Known allergy or hypersensitivity to aripiprazole or other dihidrocarbostyrils
- History of a clinically significant low white blood cell count or a drug-induced leukopenia/neutropenia
- Any other medically significant abnormal laboratory test or vital sign result or electrocardiogram finding
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo Placebo - Aripiprazole Aripiprazole -
- Primary Outcome Measures
Name Time Method Percentage of Patients Relapsing by Week 16 From end of Phase 1 (Date of randomization) to Week 16 of Phase 2 and end of treatment Time of relapse=date when patient meets relapse criteria. There are 4 definitions for relapse: 1. Patient meets the following criteria for 2 consecutive visits: (a) Aberrant Behavior Checklist Irritability score ≥25% than score at end of Phase 1 AND (b) Clinical Global Impression Improvement scale rating of 'Much Worse' or 'Very Much Worse' relative to rating at end of Phase 1. If relapse criteria met at 1 visit, 2nd visit should occur in about 1 week to reevaluate whether relapse criteria are still met. 2. Patient discontinues for "Lost to Follow-up" after a visit in which he or she met Definition 1 criteria (a\&b). 3. Patient begins a prohibited drug (whether a study investigator or outside source prescribed) to treat worsening symptoms of irritability of autistic disorder after a visit where patient met Definition 1 criteria (a\&b). 4. Patient discontinues due to hospitalization for worsening symptoms of irritability or due to lack of efficacy based on investigator's assessment.
- Secondary Outcome Measures
Name Time Method Adjusted Mean Change From Baseline to Week 16 on the Aberrant Behavior Checklist Irritability (ABC-I) Subscale Score (Last Observation Carried Forward [LOCF]) From Baseline (end of Phase 1) to Week 16 of Phase 2 ABC is an informant-based checklist used to assess and classify problem behaviors of children and adolescents with mental retardation. The 58 items are rated on a 4-point scale (0=not at all a problem to 3=the problem is severe in degree), and resolve into 5 subscales: 1) irritability, agitation; 2) lethargy, social withdrawal; 3) stereotypic behavior; 4) hyperactivity, noncompliance; and 5) inappropriate speech. The ABC can be completed by parents, special educators, psychologists, direct caregivers, nurses, and others knowing the participant. Psychometric assessment of the ABC indicates that its subscales have high internal consistency, adequate reliability, and established validity. The ABC-I Subscale Score ranges from 0 to 45, with a negative change in score signifying improvement. LOCF data set includes data recorded at a given visit or, if no observation was recorded at that visit, data carried forward from the prior visit. chg=change; BL=baseline; APR=aripiprazole; vs=versus.
Change From Baseline in Mean Clinical Global Impression Improvement (CGI-I) Scale Score at Week 16 (Last Observation Carried Forward [LOCF]) From Baseline (end of Phase 1) to Week 16 of Phase 2 CG-I rating scale permits global evaluation of patient's improvement over time. At baseline (BL), CGI Severity of Illness assessment is performed, in which the clinician rates severity of patient's condition on a 7-point scale ranging from 1=no symptoms to 7=very severe symptoms. Higher total score=worse symptoms. At subsequent visits, clinician assesses patient's improvement relative to symptoms at baseline on CGI-I 7-point scale ranging from 1=very much improved to 7=very much worse. Since the drug targets irritability symptoms, the CGI focuses on severity of irritability secondary to autistic disorder. Lower score=more improved symptoms. LOCF data set includes data recorded at a given visit or, if nothing recorded, data areccarried forward from the prior visit. For secondary endpoints (endpt), hierarchical testing was used to keep overall experiment-wise type I error rate to \<=0.05. diff=difference; IS=irritability scale; PA=primary analysis; signif=significance/significantly.
Number of Participants With Death as Outcome, Serious Adverse Events (SAEs), and Adverse Events (AEs) Leading to Discontinuation During Phase 1 Weekly from Week 1 to Week 26 and continuously to end of treatment AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE=a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization.
Trial Locations
- Locations (38)
Childrens Specialty Gr., Pllc
🇺🇸Norfolk, Virginia, United States
Stony Brook University School Of Medicine
🇺🇸Stony Brook, New York, United States
Children'S Specialized Hosp
🇺🇸Toms River, New Jersey, United States
Abbey Neuropsychology Clinic
🇺🇸Palo Alto, California, United States
Institute For Behavioral Medicine, Llc
🇺🇸Smyrna, Georgia, United States
Cyn3rgy Research
🇺🇸Gresham, Oregon, United States
Clinical Innovations, Inc.
🇺🇸Costa Mesa, California, United States
Tulsa Clinical Research, Llc
🇺🇸Tulsa, Oklahoma, United States
Behavioral Research Specialists, Llc
🇺🇸Glendale, California, United States
Insite Clinical Research
🇺🇸Desoto, Texas, United States
Kootenai Behavioral Health Center
🇺🇸Coeur D'Alene, Idaho, United States
Neurocare, Inc.
🇺🇸Newton, Massachusetts, United States
Ericksen Research And Development
🇺🇸Clinton, Utah, United States
The Ohio State University Nisonger Center
🇺🇸Columbus, Ohio, United States
Drexel University College Of Medicine
🇺🇸Philadelphia, Pennsylvania, United States
University Hospitals Case Medical Center
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
Center For Psychiatry And Behavioral Medicine, Inc
🇺🇸Las Vegas, Nevada, United States
Ucsf - Lppi
🇺🇸San Francisco, California, United States
Harmonex Neuroscience Research, Inc
🇺🇸Dothan, Alabama, United States
Palm Springs Research Institute
🇺🇸Hialeah, Florida, United States
Children'S National Medical Center
🇺🇸Washington, District of Columbia, United States
Miami Children'S Hospital
🇺🇸Miami, Florida, United States
Stanford University School Of Medicine
🇺🇸Stanford, California, United States
Florida Clinical Research Center, Llc
🇺🇸Maitland, Florida, United States
Lsu Health Sciences Center
🇺🇸Shreveport, Louisiana, United States
Holston Medical Group
🇺🇸Kingsport, Tennessee, United States
Western Psychiatric Institute And Clinic
🇺🇸Pittsburgh, Pennsylvania, United States
Southwest Autism Research And Resource Center
🇺🇸Phoenix, Arizona, United States
Sarkis Clinical Trials
🇺🇸Gainesville, Florida, United States
University Of South Florida
🇺🇸Tampa, Florida, United States
Kosair Charities Pediatric Clinical Research Unit
🇺🇸Louisville, Kentucky, United States
Unc Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
Cutting Edge Research Group
🇺🇸Oklahoma City, Oklahoma, United States
Ou Physician'S Child Study Center
🇺🇸Oklahoma City, Oklahoma, United States
Virginia Treatment Center For Children
🇺🇸Richmond, Virginia, United States
Clinical Research Center Of New Jersey
🇺🇸Gibbsboro, New Jersey, United States
Neurobehavioral Medicine Group
🇺🇸Bloomfield Hills, Michigan, United States