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An Open-label Study of NRP104 in Adults With Attention Deficit Hyperactivity Disorder (ADHD)

A Long-Term, Open-Label, and Single-Arm Study of NRP104 30 mg, 50 mg, or 70 mg Per Day in Adults With Attention Deficit Hyperactivity Disorder (ADHD)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00337285
Enrollment
349
Registered
2006-06-15
Start date
2006-07-31
Completion date
2008-06-30
Last updated
2012-08-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Attention Deficit Disorders With Hyperactivity, Attention Deficit Hyperactivity Disorder, Attention Deficit Hyperactivity Disorders

Keywords

Attention Deficit Hyperactivity Disorder, Attention Deficit Disorders with Hyperactivity, Attention Deficit Hyperactivity Disorders

Brief summary

The purpose of this study is to assess the long-term safety and efficacy of three NRP104 doses of 30 mg, 50 mg, or 70 mg, administered at the same time daily, in the treatment of adults with ADHD.

Detailed description

This is a multi-center, open-label, and single-arm study to assess the safety of three NRP104 doses (30 mg, 50 mg, or 70 mg per day) for up to one (1) year in the treatment of adults with ADHD. Subjects who were randomized and met all inclusion/exclusion criteria in Protocol NRP104.303 are eligible for participation in this protocol. The study will consist of three periods: a screening/baseline period, a 4-week dose titration, and a long-term maintenance of up to 11 months. There are three possibilities for subjects that rollover from the NRP104.303 protocol. They are: Subjects that rollover at the final visit of the NRP104.303 study (on the same day): The screening and baseline procedures from this open label study will coincide with the final study visit of Protocol NRP104.303. Subject data from final study visit will be transferred and utilized for the open label study. On this same day, the subject will be consented for NRP104.304, inclusion/exclusion criteria will be assessed, the subject will be enrolled, and study medication will be dispensed. Subjects that rollover not on the same day but within seven days of the NRP104.303 study: If the subject returns to enroll into the NRP104.304 study within seven days of the final NRP104.303 study visit and has not taken any excluded medications for which a washout is required, the final study visit procedures and data from the NRP104.303 study will be transferred and utilized for the screening and baseline visit procedures of this study, where applicable. When the subject returns to the site, they will be consented, inclusion and exclusion criteria will be assessed, the subject will be enrolled, and study medication will be dispensed. Subjects will require a full screening visit if more than 7 days have elapsed since they completed the NRP104.303 study: After screening results have been received by the site, the site personnel will contact the subject via telephone to inform them of continued study eligibility. During this call the subject will be instructed to stop all medications for the treatment of ADHD, if any. This call starts the washout of all psychoactive medications, which should last 7 (±2) days. During the Washout Phone Contact, the visit dates for the Baseline visit (Visit 01) and Visits 02 through 05 should be scheduled at 7-day intervals as calculated from Baseline. After the washout is complete, subjects will return to the clinic for the baseline visit (Visit 01) to have the baseline procedures performed and to receive study medication. Dose Titration All subjects will initiate treatment at NRP104 30 mg for the 1st week. At the subsequent 4 weekly visits (Visits 02, 03, 04, and 05), the subject's daily dose of NRP104 may be increased or decreased by 20 mg at weekly intervals to achieve the optimal efficacy and tolerability, if deemed appropriate by the Investigator. In this study, the maximum daily dose of NRP104 that can be received by the subject is 70 mg, and the minimum daily dose of NRP104 the subject must take to continue the treatment is 30 mg. Monthly Maintenance At the end of the initial 4-week dose titration (Visit 05), subjects will enter the long-term maintenance of up to 11 months. Monthly visits, starting with Visit 06, will have a window of ±4 days. All visits will be scheduled relative to the Baseline Visit date. The last scheduled visit of the protocol is Visit 16 at Month 12. During the long-term maintenance, the subject's dose may be increased or decreased by 20 mg at any visit, if deemed appropriate by the Investigator, to maintain optimal treatment in terms of efficacy and tolerability. All reasons for dose changes should be well documented by the investigator during the maintenance period. Subjects who cannot maintain the minimum daily dose of NRP 30 mg due to intolerance will be withdrawn from the study. Safety and Efficacy Assessments ADHD Rating Scale (ADHD-RS) performed using adult prompts and Clinical Global Impression (CGI) will be assessed by the Investigator. The Pittsburgh Sleep Quality Index (PSQI) will be assessed once every three months following baseline. Adverse events and concomitant medications will be recorded at each visit starting from the baseline visit. Vital signs will be measured at each visit from the screening visit. Physical exam and clinical laboratory tests (including pregnancy tests) will be assessed at Screening, Visit 10 and the final visit. Weight will be measured at the screening visit, baseline visit, and every month thereafter. Height will be measured at the screening visit and final visit. ECG parameters will be assessed at the screening visit, baseline visit, and every 3 months thereafter.

Interventions

DRUGVyvanse (lisdexamfetamine dimesylate), NRP104

NRP104 capsule once-a-day orally beginning at 30mg/day and titrated by 20 mg per day at weekly intervals up to a maximum daily dose of 70 mg

Sponsors

Shire
CollaboratorINDUSTRY
New River Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No

Inclusion criteria

* Subject must be 18-55 years of age, inclusive, at the time of consent of the NRP104.303 study. * Subject must have been randomized and must have met all inclusion/

Exclusion criteria

in the NRP104.303 study. * Subject must be male or non-pregnant female. Females of childbearing potential (FOCP) must comply with contraceptive restrictions noted in the protocol. * Subject must have a satisfactory medical assessment with no clinically significant or relevant abnormalities as determined by medical history, PE, clinical and laboratory evaluation. * In the opinion of the investigator, the subject understands and is able, willing, and likely to fully comply with the study procedures and restrictions. * Subject must have given written, personally signed and dated informed consent to participate in the study in accordance with the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines and applicable regulations before completing any study specific procedures. * Subject experienced no adverse events in a previous study of NRP104 or elsewhere that would preclude continued exposure to NRP104.

Design outcomes

Primary

MeasureTime frameDescription
Change in ADHD-RS-IV Total Score From Baseline at Up to One Yearup to one yearChange in the Attention Deficit Hyperactivity Disorder Rating Scale-fourth edition (ADHD-RS-IV) total score from baseline. The ADHD-RS-IV consists of 18 items scored on a 4-point scale ranging from 0 (no symptoms) to 3 (severe symptoms) with total score ranging from 0 to 54.

Secondary

MeasureTime frameDescription
Number of Participants With Improvement on CGI-IUp to 1 yearClinical Global Impression-Improvement (CGI-I) consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement includes 1 and 2 on the scale.
Change in PSQI Total Score From Baseline at Up to One Yearup to 1 yearPittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire consisting of 18 items which generates seven component scores on a scale from 0 (better sleep) to 3 (worse sleep) resulting in a global score of 0-21, where a higher number reflects worse sleep quality.

Countries

United States

Participant flow

Pre-assignment details

Subjects received a 30, 50, or 70 mg once daily dose of Vyvanse for up to 1 year.

Participants by arm

ArmCount
Vyvanse
Subjects received a 30, 50, or 70 mg once daily dose of Vyvanse (Lisdexamfetamine dimesylate) for up to 1 year.
349
Total349

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event28
Overall StudyDeath1
Overall StudyLack of Efficacy11
Overall StudyLack of protocol compliance7
Overall StudyLost to Follow-up41
Overall StudyPhysician Decision1
Overall StudyProtocol Violation27
Overall StudyWithdrawal by Subject42

Baseline characteristics

CharacteristicVyvanse
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
349 Participants
Age Continuous35.8 years
STANDARD_DEVIATION 10.1
Region of Enrollment
United States
349 participants
Sex: Female, Male
Female
159 Participants
Sex: Female, Male
Male
190 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
306 / —
serious
Total, serious adverse events
8 / —

Outcome results

Primary

Change in ADHD-RS-IV Total Score From Baseline at Up to One Year

Change in the Attention Deficit Hyperactivity Disorder Rating Scale-fourth edition (ADHD-RS-IV) total score from baseline. The ADHD-RS-IV consists of 18 items scored on a 4-point scale ranging from 0 (no symptoms) to 3 (severe symptoms) with total score ranging from 0 to 54.

Time frame: up to one year

Population: Intent-to-treat (ITT). Defined as all subjects who were treated and had both the baseline and at least one post-baseline primary efficacy measurement (i.e., ADHD-RS-IV total score)

ArmMeasureValue (MEAN)Dispersion
VyvanseChange in ADHD-RS-IV Total Score From Baseline at Up to One Year-24.8 Units on a scaleStandard Deviation 11.7
p-value: <0.0001t-test, 2 sided
Secondary

Change in PSQI Total Score From Baseline at Up to One Year

Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire consisting of 18 items which generates seven component scores on a scale from 0 (better sleep) to 3 (worse sleep) resulting in a global score of 0-21, where a higher number reflects worse sleep quality.

Time frame: up to 1 year

Population: Safety population (Defined as all subjects who were enrolled and who received at least one dose of the investigational product.)

ArmMeasureValue (MEAN)Dispersion
VyvanseChange in PSQI Total Score From Baseline at Up to One Year-1.3 Units on a scaleStandard Deviation 2.8
p-value: <0.0001t-test, 2 sided
Secondary

Number of Participants With Improvement on CGI-I

Clinical Global Impression-Improvement (CGI-I) consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement includes 1 and 2 on the scale.

Time frame: Up to 1 year

Population: ITT

ArmMeasureValue (NUMBER)
VyvanseNumber of Participants With Improvement on CGI-I290 Participants

Source: ClinicalTrials.gov · Data processed: Feb 5, 2026