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Safety and Efficacy of Methylphenidate in Children With Attention-deficit Hyperactivity Disorder (ADHD)

An Open-label, Randomized, Rater-blinded, Cross-over, Multicenter Study Comparing the Clinical Efficacy of Methylphenidate (Immediate Release/Extended Release) Treatment (20 or 40 mg Orally od) in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Under Different Breakfast Conditions Over Two Weeks

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00428792
Enrollment
150
Registered
2007-01-30
Start date
2007-04-30
Completion date
2007-12-31
Last updated
2011-05-06

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

Conditions

Attention Deficit Hyperactivity Disorder

Keywords

ADHD, methylphenidate, children, food effect, Attention-Deficit Hyperactivity Disorder (ADHD) in children

Brief summary

This study evaluated the safety and clinical effect of treatment with methylphenidate under different breakfast conditions (minimal breakfast versus standard continental breakfast) in children with Attention-Deficit Hyperactivity Disorder (ADHD).

Interventions

DRUGMethylphenidate 20 mg long-acting capsules

Sponsors

Novartis
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
No

Inclusion criteria

* Children aged 6-12 * Diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) * Current medication with either 20 mg or 40 mg immediate release methylphenidate

Exclusion criteria

* Concomitant psychiatric disorders requiring pharmacological treatment * Concomitant severe somatic disorders * Eating disorders * Addiction disorders * Very high or low body weight according to age * Known hypersensitivity to methylphenidate * Contraindications for methylphenidate Other protocol-defined inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Intent-to-Treat (ITT) PopulationFriday of each of the 2 treatment weeksThe FBB-ADHS is a 20-item rating scale. Each item describes a typical ADHD symptom. The 20 items are divided into 3 subscales: Attention deficits (9 items), hyperactivity (7 items), and impulsiveness (4 items). Each item is rated on a scale of 0 = not at all up to 3 = very much. The FBB-ADHS was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 20) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.
Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Per Protocol (PP) PopulationFriday of each of the 2 treatment weeksThe FBB-ADHS is a 20-item rating scale. Each item describes a typical ADHD symptom. The 20 items are divided into 3 subscales: Attention deficits (9 items), hyperactivity (7 items), and impulsiveness (4 items). Each item is rated on a scale of 0 = not at all up to 3 = very much. The FBB-ADHS was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 20) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Secondary

MeasureTime frameDescription
Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Impulsiveness Subscale Teacher RatingFriday of each of the 2 treatment weeksTeacher rating of the hyperactivity subscale (4 items), one of 3 subscales in the FBB-ADHS. Each item is rated on a scale of 0 = not at all up to 3 = very much. The rating was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 4) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.
Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Parent RatingSaturday of each of the 2 treatment weeksThe FBB-ADHS is a 20-item rating scale. Each item describes a typical ADHD symptom. The 20 items are divided into 3 subscales: Attention deficits (9 items), hyperactivity (7 items), and impulsiveness (4 items). Each item is rated on a scale of 0 = not at all up to 3 = very much. The FBB-ADHS was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 20) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.
10-Minute Math Test - Problems AttemptedSaturday of each of the 2 treatment weeksThe 10-Minute Math Test is a paper and pencil test consisting of several pages of math problems requiring addition, subtraction, multiplication and division calculations presented in ascending order of difficulty during a 10-minute period. Test difficulty was altered for subjects at different skill levels and ages. The number of problems attempted is an objective measure related to academic productivity. The math test was carried out on the Saturday visit at the end of each of the 2 treatment weeks under supervision of a teacher who had been trained on this test.
Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Attention Deficit Subscale Teacher RatingFriday of each of the 2 treatment weeksTeacher rating of the attention deficit subscale (9 items), one of 3 subscales in the FBB-ADHS. Each item is rated on a scale of 0 = not at all up to 3 = very much. The rating was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 9) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.
Clinical Global Impression Severity (CGI-S) Scale Score - Physician Rating of SeveritySaturday of each of the 2 treatment weeksThe CGI-S is a scale to assess the global severity of illness. The rating is determined by the investigator answering one question: Considering your total clinical experience with this particular population, how mentally ill is the patient at this time? Ratings are on a 7-point scale: 1=normal, not at all ill; 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill patients. The rating is based upon the average observed and reported symptoms, behavior, and function in the past 7 days.
Clinical Global Impression (CGI-I) Scale Score - Physician Rating of Improvement (Change in State)Saturday of each of the 2 treatment weeksThe CGI-I is a scale to assess improvement (change in state) of illness. The rating is based on the investigator answering one question: Compared to the patient's condition prior to medication, this patient's condition is: 1=very much improved since the initiation of treatment; 2=much improved; 3=minimally improved; 4=no change from baseline (the initiation of treatment); 5=minimally worse; 6= much worse; 7=very much worse since the initiation of treatment. The investigator compares the patient's overall clinical condition to the 1 week period just prior to the initiation of medication.
10-Minute Math Test - Problems SolvedSaturday of each of the 2 treatment weeksThe 10-Minute Math Test is a paper and pencil test consisting of several pages of math problems requiring addition, subtraction, multiplication and division calculations presented in ascending order of difficulty during a 10-minute period. Test difficulty was altered for subjects at different skill levels and ages. The number of problems attempted is an objective measure related to academic productivity. The math test was carried out on the Saturday visit at the end of each of the 2 treatment weeks under supervision of a teacher who had been trained on this test.
Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Hyperactivity Subscale Teacher RatingFriday of each of the 2 treatment weeksTeacher rating of the hyperactivity subscale (7 items), one of 3 subscales in the FBB-ADHS. Each item is rated on a scale of 0 = not at all up to 3 = very much. The rating was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 7) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Countries

Germany

Participant flow

Participants by arm

ArmCount
Very Light Breakfast (VLB) Then Standard Breakfast (SB)
Very light breakfast (VLB) for one week then crossover to standard breakfast (SB) for one week while taking either 20 mg or 40 mg capsules of methylphenidate once daily based on the dosage the child had taken in the month prior to study start. VLB is defined as 150 kcal for children age 6-9 and 180 kcal for children age 10-12. SB is defined as 450 kcal for girls age 6-9, 490 kcal for boys age 6-9, 550 kcal for girls age 10-12, and 600 kcal for boys age 10-12.
80
Standard Breakfast (SB) Then Very Light Breakfast (VLB)
Standard breakfast (SB) for one week then crossover to very light breakfast (VLB) for one week while taking either 20 mg or 40 mg capsules of methylphenidate once daily based on the dosage the child had taken in the month prior to study start. SB is defined as 450 kcal for girls age 6-9, 490 kcal for boys age 6-9, 550 kcal for girls age 10-12, and 600 kcal for boys age 10-12. VLB is defined as 150 kcal for children age 6-9 and 180 kcal for children age 10-12.
70
Total150

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLack of Efficacy13
Overall StudyLost to Follow-up01

Baseline characteristics

CharacteristicVery Light Breakfast (VLB) Then Standard Breakfast (SB)Standard Breakfast (SB) Then Very Light Breakfast (VLB)Total
Age Continuous9.6 years
STANDARD_DEVIATION 1.6
9.7 years
STANDARD_DEVIATION 1.5
9.7 years
STANDARD_DEVIATION 1.6
Sex: Female, Male
Female
25 Participants13 Participants38 Participants
Sex: Female, Male
Male
55 Participants57 Participants112 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
0 / 1480 / 149
serious
Total, serious adverse events
0 / 1480 / 149

Outcome results

Primary

Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Intent-to-Treat (ITT) Population

The FBB-ADHS is a 20-item rating scale. Each item describes a typical ADHD symptom. The 20 items are divided into 3 subscales: Attention deficits (9 items), hyperactivity (7 items), and impulsiveness (4 items). Each item is rated on a scale of 0 = not at all up to 3 = very much. The FBB-ADHS was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 20) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Time frame: Friday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population: All randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Intent-to-Treat (ITT) Population0.97 Units on a scaleStandard Deviation 0.63
Standard Breakfast (SB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Intent-to-Treat (ITT) Population1.01 Units on a scaleStandard Deviation 0.63
Primary

Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Per Protocol (PP) Population

The FBB-ADHS is a 20-item rating scale. Each item describes a typical ADHD symptom. The 20 items are divided into 3 subscales: Attention deficits (9 items), hyperactivity (7 items), and impulsiveness (4 items). Each item is rated on a scale of 0 = not at all up to 3 = very much. The FBB-ADHS was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 20) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Time frame: Friday of each of the 2 treatment weeks

Population: Per protocol (PP) population: All patients in the ITT population who (a) met the inclusion/exclusion criteria liable to affect the efficacy assessment and (b) did not violate the protocol in a manner liable to affect the efficacy assessment.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Per Protocol (PP) Population0.93 Units on a scaleStandard Deviation 0.62
Standard Breakfast (SB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Teacher Rating in the Per Protocol (PP) Population1.0 Units on a scaleStandard Deviation 0.63
Secondary

10-Minute Math Test - Problems Attempted

The 10-Minute Math Test is a paper and pencil test consisting of several pages of math problems requiring addition, subtraction, multiplication and division calculations presented in ascending order of difficulty during a 10-minute period. Test difficulty was altered for subjects at different skill levels and ages. The number of problems attempted is an objective measure related to academic productivity. The math test was carried out on the Saturday visit at the end of each of the 2 treatment weeks under supervision of a teacher who had been trained on this test.

Time frame: Saturday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population includes all randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods. Following the intent-to-treat principle, patients were analyzed according to the treatment they were assigned to at randomization.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment Group10-Minute Math Test - Problems Attempted116.3 Problems attemptedStandard Deviation 56.14
Standard Breakfast (SB) Treatment Group10-Minute Math Test - Problems Attempted118.1 Problems attemptedStandard Deviation 57.74
Secondary

10-Minute Math Test - Problems Solved

The 10-Minute Math Test is a paper and pencil test consisting of several pages of math problems requiring addition, subtraction, multiplication and division calculations presented in ascending order of difficulty during a 10-minute period. Test difficulty was altered for subjects at different skill levels and ages. The number of problems attempted is an objective measure related to academic productivity. The math test was carried out on the Saturday visit at the end of each of the 2 treatment weeks under supervision of a teacher who had been trained on this test.

Time frame: Saturday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population: All randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment Group10-Minute Math Test - Problems Solved106.7 Problems solvedStandard Deviation 58.34
Standard Breakfast (SB) Treatment Group10-Minute Math Test - Problems Solved108.6 Problems solvedStandard Deviation 60.67
Secondary

Clinical Global Impression (CGI-I) Scale Score - Physician Rating of Improvement (Change in State)

The CGI-I is a scale to assess improvement (change in state) of illness. The rating is based on the investigator answering one question: Compared to the patient's condition prior to medication, this patient's condition is: 1=very much improved since the initiation of treatment; 2=much improved; 3=minimally improved; 4=no change from baseline (the initiation of treatment); 5=minimally worse; 6= much worse; 7=very much worse since the initiation of treatment. The investigator compares the patient's overall clinical condition to the 1 week period just prior to the initiation of medication.

Time frame: Saturday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population includes all randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods. Following the intent-to-treat principle, patients were analyzed according to the treatment they were assigned to at randomization.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupClinical Global Impression (CGI-I) Scale Score - Physician Rating of Improvement (Change in State)3.49 Units on a scaleStandard Deviation 1.08
Standard Breakfast (SB) Treatment GroupClinical Global Impression (CGI-I) Scale Score - Physician Rating of Improvement (Change in State)3.56 Units on a scaleStandard Deviation 1.18
Secondary

Clinical Global Impression Severity (CGI-S) Scale Score - Physician Rating of Severity

The CGI-S is a scale to assess the global severity of illness. The rating is determined by the investigator answering one question: Considering your total clinical experience with this particular population, how mentally ill is the patient at this time? Ratings are on a 7-point scale: 1=normal, not at all ill; 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill patients. The rating is based upon the average observed and reported symptoms, behavior, and function in the past 7 days.

Time frame: Saturday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population: All randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupClinical Global Impression Severity (CGI-S) Scale Score - Physician Rating of Severity2.75 Units on a scaleStandard Deviation 1.45
Standard Breakfast (SB) Treatment GroupClinical Global Impression Severity (CGI-S) Scale Score - Physician Rating of Severity2.74 Units on a scaleStandard Deviation 1.48
Secondary

Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Attention Deficit Subscale Teacher Rating

Teacher rating of the attention deficit subscale (9 items), one of 3 subscales in the FBB-ADHS. Each item is rated on a scale of 0 = not at all up to 3 = very much. The rating was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 9) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Time frame: Friday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population: All randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Attention Deficit Subscale Teacher Rating1.19 Units on a scaleStandard Deviation 0.68
Standard Breakfast (SB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Attention Deficit Subscale Teacher Rating1.23 Units on a scaleStandard Deviation 0.69
Secondary

Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Hyperactivity Subscale Teacher Rating

Teacher rating of the hyperactivity subscale (7 items), one of 3 subscales in the FBB-ADHS. Each item is rated on a scale of 0 = not at all up to 3 = very much. The rating was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 7) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Time frame: Friday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population: All randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Hyperactivity Subscale Teacher Rating0.72 Units on a scaleStandard Deviation 0.7
Standard Breakfast (SB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Hyperactivity Subscale Teacher Rating0.75 Units on a scaleStandard Deviation 0.69
Secondary

Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Impulsiveness Subscale Teacher Rating

Teacher rating of the hyperactivity subscale (4 items), one of 3 subscales in the FBB-ADHS. Each item is rated on a scale of 0 = not at all up to 3 = very much. The rating was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 4) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Time frame: Friday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population: All randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Impulsiveness Subscale Teacher Rating0.93 Units on a scaleStandard Deviation 0.92
Standard Breakfast (SB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Impulsiveness Subscale Teacher Rating0.99 Units on a scaleStandard Deviation 0.9
Secondary

Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Parent Rating

The FBB-ADHS is a 20-item rating scale. Each item describes a typical ADHD symptom. The 20 items are divided into 3 subscales: Attention deficits (9 items), hyperactivity (7 items), and impulsiveness (4 items). Each item is rated on a scale of 0 = not at all up to 3 = very much. The FBB-ADHS was completed by teachers on Friday afternoon of each week of the study. A total score (sum of all items divided by 20) was calculated. The total score can range from 0 to 3. A lower score indicates more ADHD.

Time frame: Saturday of each of the 2 treatment weeks

Population: Intent to treat (ITT) population: All randomized patients with at least one post-baseline measurement of the primary endpoint in both study periods.

ArmMeasureValue (MEAN)Dispersion
Very Light Breakfast (VLB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Parent Rating1.15 Units on a scaleStandard Deviation 0.6
Standard Breakfast (SB) Treatment GroupFremdbeurteilungsbogen für Aufmerksamkeitsdefizit-Hyperaktivitätsstörungen (FBB-AHDS) Parent Rating1.11 Units on a scaleStandard Deviation 0.55

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026