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Riluzole in Fragile X Syndrome

Riluzole in Fragile X Syndrome: A Pilot Study Incorporating Biomarker Assay

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00895752
Enrollment
6
Registered
2009-05-08
Start date
2009-04-30
Completion date
2010-07-31
Last updated
2017-04-18

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

Conditions

Fragile X Syndrome

Brief summary

The purpose of this study is to investigate the effectiveness and tolerability of riluzole in adults with Fragile X Syndrome.

Detailed description

Fragile X Syndrome (FXS) represents the most common inherited form of intellectual disability. FXS is more common in males and the symptoms associated with the disorder are more marked in males. FXS is associated with characteristic physical features, behaviors, and comorbidities. Those with FXS often suffer from behavioral difficulties that include anxiety-related symptoms (shyness, social phobia, obsessive-compulsive disorder (OCD) symptoms), attention deficit hyperactivity symptoms (overarousal, hyperactivity, distractibility, impulsivity) and aggressive/self-injurious behaviors. Riluzole is approved by the FDA for use in treating amyotrophic lateral sclerosis (ALS) in adults. Recently, riluzole has been the subject of several open-label studies describing the use of the drug in treatment-resistant depression and OCD. Given the overlap between repetitive behavior in FXS and symptoms of OCD, it is logical to study riluzole in FXS given the compound's promise in ameliorating treatment-refractory symptoms of OCD.

Interventions

DRUGRiluzole

Six week open-label treatment with riluzole, maximum dose of 50 mg twice a day.

Sponsors

Indiana Clinical and Translational Sciences Institute
CollaboratorOTHER
Indiana University
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Males and females age 18 years or older. * Confirmed molecular diagnosis of Fragile X Syndrome. * Clinical Global Impression Severity (CGI-S) score of 3 or greater. * Significant interfering repetitive behavior as determined by the principal investigator. * Must be in good health as determined by screening procedures including a detailed medical history, and complete physical and neurological examination. * Dosing of concomitant medications during the study must remain stable.

Exclusion criteria

* Pregnancy. * Concomitant use of another glutamatergic agent (memantine, topiramate, amantadine, among others. * Evidence of prior trial of riluzole and/or hypersensitivity/allergic reaction to riluzole. * Abnormal baseline liver function tests at screen or by history; or complete blood count abnormalities at screen or by history.

Design outcomes

Primary

MeasureTime frameDescription
Clinical Global Impression-Improvement (CGI-I)Obtained at Week 6The Clinical Global Impression - Improvement scale (CGI-I) is a 7 point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention. and rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse
Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)Obtained at Baseline and Week 6The CY-BOCS PDD has been utilized in a largescale clinical treatment study of repetitive behavior in idiopathic ASDs. CYBOCS-PDD scores range from 0 to 20 and measure repetitive/compulsive behavior and not obsessions. Higher score indicate worse outcome.

Secondary

MeasureTime frameDescription
The Clinical Global Impression - Severity ScaleWeek 6The Clinical Global Impression - Severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis. Considering total clinical experience, a patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill
The Peabody Picture Vocabulary TestWeek 6The Peabody Picture Vocabulary Test is one of the most commonly used assessment tests that measure verbal ability in standard American English vocabulary. This test has been nationally standardized using examinees from various age groups, from children to adults. Thus, the raw scores are equated to mental age, using the norms obtained from standardization. The total standard scores range from 40 (worse receptive vocabulary) to 160 (better receptive vocabulary). The scores can also be converted to percentile rank.
Aberrant Behavior ChecklistWeek 6The Aberrant Behavior Checklist (ABC) is a 58-item measure of maladaptive behaviors and is used as a measure of drug effects. The ABC has 5 subscales: Social Withdrawal (16 items) ranging from 0 (not at all) to 48 (severe), Irritability (15 items) ranging from 0 (not at all) to 45 (severe), Inappropriate Speech (4 items) ranging from 0 (not at all) to 12 (severe), Hyperactivity (16 items) ranging from 0 (not at all) to 48 (severe), and Stereotypy (7 items) ranging from 0 (not at all) to 21 (severe). Items are rated from 0 (not at all) to 3 (severe).
Extra-cellular Signal-relatedness Kinase (ERK)Screen and Week 6ERK activations times, as defined as the time in minutes for ERK phosphorylation to reach the half maximal level.
The Social Reciprocity ScaleWeek 6The 65-item SRS is a standardized measure of the core symptoms of autism. Each item is scored on a 4-point Likert scale. The score of each individual item is summed to create a total raw score. A total scores results are as follows: 0-62: Within normal limits 63-79: Mild range of impairment 80-108: Moderate range of impairment 109-149: Severe range of impairment.
The ADHD Rating ScaleWeek 6The ADHD Rating Scale is an 18-item scale directly derived from DSM-IV criteria for Attention Deficit Hyperactivity Disorder. The ADHD Rating Scale-IV is completed by the parent and scored by a clinician. The scale consists of 2 subscales: inattention (9 items) and hyperactivity-impulsivity (9 items). If 3 or more items are skipped, the clinician should use extreme caution in interpreting the scale. The total score can range from 0 to 54, with a higher score indicating greater severity

Countries

United States

Participant flow

Participants by arm

ArmCount
Riluzole
Six subjects received 6-weeks of open-label riluzole with maximum dose of 50mg bid.
6
Total6

Baseline characteristics

CharacteristicRiluzole
Aberrant Behavior Checklist
ABC Hyperactivity
19.5 units on a scale
STANDARD_DEVIATION 8.3
Aberrant Behavior Checklist
ABC Inappropriate Speech
8.5 units on a scale
STANDARD_DEVIATION 2.7
Aberrant Behavior Checklist
ABC Irritability
15.2 units on a scale
STANDARD_DEVIATION 11.4
Aberrant Behavior Checklist
ABC Social Withdrawal
15.8 units on a scale
STANDARD_DEVIATION 11
Aberrant Behavior Checklist
ABC Stereotypy
8.3 units on a scale
STANDARD_DEVIATION 7.8
ADHD rating scale24.3 units on a scale
STANDARD_DEVIATION 8.4
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
6 Participants
Age, Continuous22.5 years
Children's Yale-Brown Obsessive Compulsive Scale modified for pervasive developmental disorders11.2 units on a scale
STANDARD_DEVIATION 3.2
Clinical Global Improvement-Severity4.3 units on a scale
STANDARD_DEVIATION 0.5
Peabody Picture Vocabulary Test116.8 units on a scale
STANDARD_DEVIATION 40.2
Region of Enrollment
United States
6 participants
Sex: Female, Male
Female
0 Participants
Sex: Female, Male
Male
6 Participants
Social Reciprocity Scale114.7 units on a scale
STANDARD_DEVIATION 23.6

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
3 / 6
serious
Total, serious adverse events
0 / 6

Outcome results

Primary

Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)

The CY-BOCS PDD has been utilized in a largescale clinical treatment study of repetitive behavior in idiopathic ASDs. CYBOCS-PDD scores range from 0 to 20 and measure repetitive/compulsive behavior and not obsessions. Higher score indicate worse outcome.

Time frame: Obtained at Baseline and Week 6

ArmMeasureGroupValue (MEAN)Dispersion
RiluzoleChildren's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)Six Weeks9.7 Units on a ScaleStandard Deviation 3.3
RiluzoleChildren's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)Baseline11.2 Units on a ScaleStandard Deviation 3.2
Primary

Clinical Global Impression-Improvement (CGI-I)

The Clinical Global Impression - Improvement scale (CGI-I) is a 7 point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention. and rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse

Time frame: Obtained at Week 6

ArmMeasureValue (MEAN)
RiluzoleClinical Global Impression-Improvement (CGI-I)3.5 units on a scale
Secondary

Aberrant Behavior Checklist

The Aberrant Behavior Checklist (ABC) is a 58-item measure of maladaptive behaviors and is used as a measure of drug effects. The ABC has 5 subscales: Social Withdrawal (16 items) ranging from 0 (not at all) to 48 (severe), Irritability (15 items) ranging from 0 (not at all) to 45 (severe), Inappropriate Speech (4 items) ranging from 0 (not at all) to 12 (severe), Hyperactivity (16 items) ranging from 0 (not at all) to 48 (severe), and Stereotypy (7 items) ranging from 0 (not at all) to 21 (severe). Items are rated from 0 (not at all) to 3 (severe).

Time frame: Week 6

ArmMeasureGroupValue (MEAN)Dispersion
RiluzoleAberrant Behavior ChecklistIrritablity8.3 units on a scaleStandard Deviation 7.7
RiluzoleAberrant Behavior ChecklistSocial Withdrawal9.7 units on a scaleStandard Deviation 8
RiluzoleAberrant Behavior ChecklistStereotypy5.3 units on a scaleStandard Deviation 6.4
RiluzoleAberrant Behavior ChecklistHyperactivity15.0 units on a scaleStandard Deviation 9.2
RiluzoleAberrant Behavior ChecklistInappropriate Speech6.2 units on a scaleStandard Deviation 4
Secondary

Extra-cellular Signal-relatedness Kinase (ERK)

ERK activations times, as defined as the time in minutes for ERK phosphorylation to reach the half maximal level.

Time frame: Screen and Week 6

ArmMeasureValue (MEAN)Dispersion
RiluzoleExtra-cellular Signal-relatedness Kinase (ERK)2.99 minutesStandard Deviation 0.3
Secondary

The ADHD Rating Scale

The ADHD Rating Scale is an 18-item scale directly derived from DSM-IV criteria for Attention Deficit Hyperactivity Disorder. The ADHD Rating Scale-IV is completed by the parent and scored by a clinician. The scale consists of 2 subscales: inattention (9 items) and hyperactivity-impulsivity (9 items). If 3 or more items are skipped, the clinician should use extreme caution in interpreting the scale. The total score can range from 0 to 54, with a higher score indicating greater severity

Time frame: Week 6

ArmMeasureValue (MEAN)Dispersion
RiluzoleThe ADHD Rating Scale19.0 units on a scaleStandard Deviation 9.7
Secondary

The Clinical Global Impression - Severity Scale

The Clinical Global Impression - Severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis. Considering total clinical experience, a patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill

Time frame: Week 6

ArmMeasureValue (MEAN)Dispersion
RiluzoleThe Clinical Global Impression - Severity Scale4.2 units on a scaleStandard Deviation 0.4
Secondary

The Peabody Picture Vocabulary Test

The Peabody Picture Vocabulary Test is one of the most commonly used assessment tests that measure verbal ability in standard American English vocabulary. This test has been nationally standardized using examinees from various age groups, from children to adults. Thus, the raw scores are equated to mental age, using the norms obtained from standardization. The total standard scores range from 40 (worse receptive vocabulary) to 160 (better receptive vocabulary). The scores can also be converted to percentile rank.

Time frame: Week 6

ArmMeasureValue (MEAN)Dispersion
RiluzoleThe Peabody Picture Vocabulary Test123.2 units on a scaleStandard Deviation 36.6
Secondary

The Social Reciprocity Scale

The 65-item SRS is a standardized measure of the core symptoms of autism. Each item is scored on a 4-point Likert scale. The score of each individual item is summed to create a total raw score. A total scores results are as follows: 0-62: Within normal limits 63-79: Mild range of impairment 80-108: Moderate range of impairment 109-149: Severe range of impairment.

Time frame: Week 6

ArmMeasureValue (MEAN)Dispersion
RiluzoleThe Social Reciprocity Scale103.5 units on a scaleStandard Deviation 24.4

Source: ClinicalTrials.gov · Data processed: Mar 19, 2026