A Phase 3, Multicenter, Randomized, Double-blind, Placebo Controlled Trial of Brexpiprazole in Treatment of Children and Adolescents With Irritability Associated With Autism Spectrum Disorder
Overview
- Phase
- Phase 3
- Intervention
- Brexpiprazole
- Conditions
- Irritability Associated With Autism Spectrum Disorder (ASD)
- Sponsor
- Otsuka Pharmaceutical Development & Commercialization, Inc.
- Enrollment
- 119
- Locations
- 1
- Primary Endpoint
- Mean Change From Baseline to Week 8 in Aberrant Behavior Checklist - Irritability (ABC-I) Subscale Score
- Status
- Completed
- Last Updated
- 8 months ago
Overview
Brief Summary
The purpose of this study is to find out about the potential benefits and safety of brexpiprazole in children and adolescent participants, aged 5 to 17, with irritability associated with autism spectrum disorder.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Primary Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis of ASD
- •Aberrant Behavior checklist - Irritability (ABC-I) subscale score of ≥ 18
- •Clinical Global Impressions - Severity (CGI-S) scale score pertaining to irritability ≥ 4
- •Mental age of ≥ 2 years as determined by Investigator based upon school participation, social history or medical records
- •Ability for parent/caregiver to follow all protocol procedures
- •Able to swallow tablets
- •Able to discontinue all prohibited concomitant medications to meet protocol required washouts prior to and during the trial period
Exclusion Criteria
- •Primary diagnosis of bipolar I disorder, including any DSM-5 current diagnosis of bipolar II disorder, schizophrenia, schizoaffective disorder, major depressive episode, and post-traumatic stress disorder (PTSD). Attention-deficit/hyperactivity disorder (ADHD) maybe exclusionary if it is the primary disorder, or is not stable or adequately treated.
- •current or historical diagnosis of Fragile-X Syndrome or Rett's Disorder
- •history of neuroleptic malignant syndrome
- •a significant risk of committing violent acts, serious self-harm, or suicide
- •epilepsy, a history of seizures, or a history of severe head trauma or stroke, or have a history or current evidence of other unstable medical conditions
- •current hypothyroidism or hyperthyroidism
- •uncontrolled Type I or Type II diabetes
- •uncontrolled hypertension or symptomatic hypotension, or orthostatic hypotension
- •Weight \< 15 kg
- •Previous exposure to brexpiprazole
Arms & Interventions
Brexpiprazole
Participants received flexible doses of brexpiprazole 0.25 to 3 milligram per day (mg/day), orally, once daily (QD) up to Week 8. For participants with body weight \< 50 kilograms (kg) the dose was titrated up from 0.25 mg/day on Days 1 to 3, followed by 0.5 mg on Days 4 to 7, and to 1 mg on Days 8 to 14. Based on the investigator's judgment the dose was increased to 1.5 mg/day after Day 15. The dose was fixed after Week 6 and administration continued for another 2 weeks until Week 8. For participants with body weight ≥ 50 kg the dose was titrated up from 0.5 mg/day on Days 1 to 3, followed by 1.5 mg on Days 4 to 7, and to 2 mg on Days 8 to 14. Based on the investigator's judgment the dose was increased to 3 mg/day after Day 15. The dose was fixed after Week 6 and administration continued for another 2 weeks until Week 8.
Intervention: Brexpiprazole
Placebo
Participants received brexpiprazole matching placebo orally, QD, in the same way as brexpiprazole up to Week 8.
Intervention: Placebo
Outcomes
Primary Outcomes
Mean Change From Baseline to Week 8 in Aberrant Behavior Checklist - Irritability (ABC-I) Subscale Score
Time Frame: Baseline to Week 8
The ABC is a parent-reported rating scale designed to assess treatment effects on problem behavior in participants with intellectual disabilities. The ABC scale has 58 items, which divide into 5 subscales as follows: (1) Irritability, Agitation; (2) Lethargy, Social Withdrawal; (3) Stereotypic Behavior; (4) Hyperactivity, Noncompliance; and (5) Inappropriate Speech. Each of the 58 ABC items is rated on a 4-point scale (0=not at all a problem; 1=the behavior is a problem, but slight in degree;2=the problem is moderately serious; 3=the problem is severe in degree). ABC-I measures emotional and behavioral symptoms of ASD, including aggression toward others, deliberate self-injuriousness, temper tantrums, and quickly changing moods. ABC-I total score is the sum of the ratings over 15 ABC items. Individual scores were summed, thus the ABC-I total score ranges from 0 to 45. Higher scores represent the worst condition. A negative change from baseline indicates improvement.
Secondary Outcomes
- Mean Change From Baseline to Week 8 in Clinical Global Impression - Severity (CGI-S) Score(Baseline to Week 8)