Clinical trial NCT03887676: Arbaclofen vs. Placebo in the Treatment of Children and Adolescents With ASD (ARBA)
Official title: A Randomized Placebo-controlled Trial of ARBaclofen vs. Placebo in the Treatment of Children and Adolescents With ASD
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
Conditions: Autism Spectrum Disorder
Keywords: ASD
Autism
Lead sponsor: Anagnostou, Evdokia, M.D.
Sponsor class: INDIV
Collaborators: name: Holland Bloorview Kids Rehabilitation Hospital
name: McMaster University
name: University of Western Ontario, Canada
name: Queen's University
name: Unity Health Toronto
name: University of Toronto
First posted: 2019-03-25
Enrollment: 90
Sex: ALL
Minimum age (years): 5
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study will examine the safety and efficacy of arbaclofen vs. placebo on social function in children and adolescents with Autism Spectrum Disorder (ASD).

Detailed description: There are no pharmacologic treatments available for social function deficits in individuals with ASD. The data for pharmacologic treatment of repetitive behaviours in this disorder has also become difficult to interpret given that the last two large multisite trials of selective serotonin reuptake inhibitors (SSRIs) in autism are reported to be negative for the treatment of repetitive behaviours. Only the associated symptom of irritability has 2 drugs with Food and Drug Administration (FDA) indications, whereas no systematic data exists on the pharmacologic treatment of anxiety in ASD, and response to rates to stimulants for hyperactivity are lower than what is seen in Attention Deficit Hyperactivity Disorder (ADHD). In addition, there are no biological markers of treatment response identified in this population at this point. This study will examine the potential efficacy and safety of arbaclofen for social function, and will explore biological markers of safety and treatment response.

Eligibility criteria: Inclusion Criteria:

1. Outpatients 5-17 years of age inclusive.
2. Meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). DSM-5 criteria will be established by a clinician with expertise with individuals with ASD. Diagnosis will be supported by the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2).
3. Complex language to qualify for ADOS-2 modules 3 or 4.
4. If already receiving stable concomitant medications affecting behaviour, have stable regimens with no changes during the preceding 6 weeks prior to Screening, and will not electively initiate new or modify ongoing medications for the duration of the study.
5. If already receiving stable non-pharmacological educational and behavioural interventions, have continuous participation during the preceding 3 months prior to Screening, and will not electively initiate new or modify ongoing interventions for the duration of the study.
6. Have normal physical examination and laboratory test results at Screening. If abnormal, the finding(s) must be deemed clinically insignificant by the Investigator.
7. Ability to obtain written informed consent from the participant, if developmentally appropriate. If a participant does not have the capacity to consent, ability to obtain assent (if developmentally appropriate), as well as written informed consent from their parent(s)/legal guardian(s).

Exclusion Criteria:

1. Pregnant females; sexually active females on inadequate birth control.
2. Have a serious medical condition that, based on Investigator judgment, might interfere with the conduct of the study, confound interpretation of the study results, or endanger their own well-being. Have evidence of any significant hematological, endocrine, cardiovascular (including uncorrected symptomatic congenital heart disease), respiratory, renal, hepatic, or gastrointestinal disease, not including mild common pediatric diseases in these areas that are stable (e.g. mild asthma, constipation, etc.).
3. Have unstable epilepsy (i.e. seizures occurring within the last 6 months), or have epilepsy and not on stable doses of antiepileptic medications (i.e. dose changes within the last 3 months).
4. Have a history of drug abuse.
5. Have hypersensitivity to arbaclofen or any components of its formulation.
6. Unable to tolerate venipuncture procedures for blood sampling.
7. Actively enrolled in another intervention study.
8. Taking racemic bacblofen, vigabatrin, tiagapine, riluzole, clobazam or regular benzodiazepine use (prn and hs use is allowed).
9. Unable to take oral medications.
10. Known hypersensitivity to racemic baclofen.
11. Inability to speak and understand English sufficiently enough to allow for the completion of all study assessments (parent/legal guardian; participant).

Primary outcomes:
measure: Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) - Social Domain
timeFrame: 16 weeks
Secondary outcomes:
measure: Clinical Global Impressions - Impression Scale - Improvement (CGI-I)
timeFrame: 16 weeks
measure: Aberrant Behavior Checklist (ABC) - Social Withdrawal Subscale
timeFrame: 16 weeks
measure: Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) - Communication Domain
timeFrame: 16 weeks
measure: Safety Monitoring Uniform Report Form (SMURF)
timeFrame: 16 weeks
measure: Clinical Global Impressions - Impression Scale - Global (CGI-I-Global)
timeFrame: 16 weeks
measure: Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD)
timeFrame: 16 weeks
measure: Suicidality assessment using the Columbia-Suicide Severity Rating Scale (C-SSRS)
timeFrame: 16 weeks
Other outcomes:
Locations:
city: Hamilton
country: Canada
facility: McMaster University, Offord Centre for Child Studies
state: Ontario
city: Kingston
country: Canada
facility: Queen's Universtiy
state: Ontario
city: London
country: Canada
facility: University of Western Ontario, Lawson Health Research Institute
state: Ontario
city: Toronto
country: Canada
facility: Holland Bloorview Kids Rehabilitation Hospital
state: Ontario
Study officials:
affiliation: Holland Bloorview Kids Rehabilitation Hospital
name: Evdokia Anagnostou, M.D
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Western Ontario, Lawson Health Research Institute
name: Robert Nicolson, M.D
role: PRINCIPAL_INVESTIGATOR
affiliation: McMaster University, Offord Centre for Child Studies
name: Julia Frei, M.D
role: PRINCIPAL_INVESTIGATOR
affiliation: Queen's University
name: Muhammad Ayub, M.D
role: PRINCIPAL_INVESTIGATOR
References: