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Safety and Efficacy of SPD489 on Executive Function Behaviors in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)

A Phase 4, Randomized, Double-Blind, Multicenter, Placebo-controlled, Parallel Group Study Evaluating the Safety and Efficacy of SPD489 on Executive Function (Self-Regulation) Behaviors in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD) Reporting Clinically Significant Impairment of Real-World Executive Function Behavior.

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01101022
Enrollment
161
Registered
2010-04-09
Start date
2010-05-19
Completion date
2010-11-29
Last updated
2021-06-09

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

Conditions

ADHD Specifically With Executive Function Impairment

Brief summary

The primary objective of the study is to evaluate the efficacy of SPD489 compared to placebo on executive function (self-regulation) behaviors in adults with ADHD who report clinically significant impairment of executive function behavior in their everyday environment, as measured by the self-report Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A) Global Executive Composite (GEC) T-score.

Interventions

DRUGSPD489

1 capsule per day (30, 50 or 70 mg), daily throughout the double-blind treatment period (10 weeks)

OTHERPlacebo

1 capsule per day, daily throughout the double-blind treatment period (10 weeks)

Sponsors

Shire
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

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

Inclusion criteria

1. Subject must be 18-55 years of age, inclusive at the time of consent. 2. Subject has an established close relationship of at least 6-months duration before screening (Visit -1) with an informant who will be able to observe and be willing to report on the subject's behavior and symptoms in multiple social settings during the course of the study. Informant is defined as a person who has a domicile relationship with the subject. When applicable, the informant should be the subject's spouse/significant other. Additionally, the informant cannot participate as a subject in the study and can only serve as the informant for a single subject. 3. Subject has a lifestyle that in the opinion of the Investigator will enable the subject to complete all study testing and requirements defined in the protocol. 4. Female subjects must have a negative serum beta human chorionic gonadotropin (HCG) pregnancy test at screening (Visit -1) and a negative urine pregnancy test at baseline (Visit 0) and agree to comply with any applicable contraceptive requirements of the protocol. 5. Subject meets the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision (DSM-IV-TR) criteria for a primary diagnosis of ADHD (diagnostic code 314.00 and 314.01) established by a comprehensive psychiatric evaluation that reviews DSM-IV-TR criteria with at least 6 of the 9 subtype criteria met. The Adult ADHD Clinical Diagnostic Scale version 1.2 (ACDS v1.2) will be utilized as the diagnostic tool. 6. Subject has a total score of ≥65 on BRIEF-A GEC T-score by self-report at baseline (Visit 0). 7. Subject has a total score of ≥28 using the Adult ADHD-RS with prompts at baseline (Visit 0). 8. Subject must have a minimum level of intellectual functioning as determined by the Investigator at screening (Visit -1). 9. Subject is able to swallow a capsule. 10. Subject is willing and able to comply with all the testing and requirements defined in this protocol. 11. Subject and informant must be able to provide 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 related procedures.

Exclusion criteria

1. Subject has a current comorbid psychiatric disorder that is either controlled with medications prohibited in this study or is uncontrolled and associated with significant symptoms. Prohibited disorders include those associated with diagnoses including but not limited to any severe comorbid Axis II disorder or severe Axis I disorder (such as Post Traumatic Stress Disorder \[PTSD\], psychosis, bipolar illness, pervasive developmental disorder, severe obsessive compulsive disorder, severe depressive or severe anxiety disorder). Other symptomatic manifestations (such as agitated states) that contraindicate treatment with SPD489 or confound efficacy or safety assessments in the opinion of the examining physician are also prohibited. Comorbid psychiatric diagnoses will be established by the psychiatric evaluation that includes the Structured Clinical Interview for DSM-IV-TR disorders (SCID-I). 2. Subjects who are currently considered a suicide risk, any subject who has previously made a suicide attempt or those who are currently demonstrating active suicidal ideation. 3. The subject has a body mass index (BMI) of \<18.5 or ≥40. 4. Subject has a concurrent chronic or acute illness (such as severe allergic rhinitis or an infectious process requiring antibiotics), disability, or other condition that might confound the results of safety assessments administered in the study or that might increase risk to the subject. Similarly, the subject will be excluded if he or she has any additional condition(s) that in the Investigator's opinion would prohibit the subject from completing the study or would not be in the best interest of the subject. This would include any significant illness or unstable medical condition that could lead to difficulty complying with the protocol. Mild, stable asthma is not exclusionary. 5. Subject has a history of seizures (other than infantile febrile seizures), any tic disorder, a current diagnosis and/or a known family history of Tourette's Disorder. 6. Subject has known history of symptomatic cardiovascular disease, advanced arteriosclerosis, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, transient ischemic attack or stroke or other serious cardiac problems that may place them at increased vulnerability to the sympathomimetic effects of a stimulant drug. 7. Subject has a known family history of sudden cardiac death or ventricular arrhythmia. 8. Subject has any clinically significant ECG or clinically significant laboratory abnormality at screening (Visit -1). 9. Subject has current abnormal thyroid function, defined as abnormal screening thyroid stimulating hormone (TSH) and thyroxine (T4). Treatment with a stable dose of thyroid medication for at least 3 months is permitted. 10. Subject has a history of moderate to severe hypertension or has a resting sitting systolic blood pressure \>139mmHg or diastolic blood pressure \>89mmHg. Subjects with well-controlled mild or moderate hypertension on a single antihypertensive agent are allowed. Combination antihypertensive medications are not allowed. 11. Subject is taking any medication that is excluded. 12. Subject has a documented allergy, hypersensitivity, or intolerance to amphetamines. 13. Subject has a documented allergy, hypersensitivity, or intolerance to any excipients in the investigational medicinal product. 14. Subject has failed to respond to one or more adequate courses (dose and duration) of amphetamine therapy. 15. Subject has a recent history (within the past 6 months) of suspected substance abuse or dependence disorder (excluding nicotine) in accordance with DSM-IV-TR criteria. 16. Subject has a positive urine drug result at screening (Visit -1) (with the exception of subject's current stimulant therapy, if any). 17. Subject has taken an investigational drug or taken part in a clinical trial, including an SPD489 clinical trial, within 30 days prior to screening (Visit -1). 18. Subject has glaucoma. 19. Subject is taking other medications that have central nervous system (CNS) effects or affect performance, such as sedating antihistamines and decongestant sympathomimetics, or are monoamine oxidase inhibitors (during or within 7 days of investigational medicinal product administration). Stable use of bronchodilator inhalers is not exclusionary. 20. Subject is female and pregnant or lactating. 21. Subjects who have previously been randomized into this study and subsequently withdrawn. 22. Subject is well controlled on their current ADHD medication with acceptable tolerability.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Subject-reported Behavior Rating Inventory of Executive Function - Adult Version Global Executive Composite T-score (BRIEF-A GEC T) at up to 10 WeeksBaseline and up to 10 weeksBRIEF-A Global Executive Composite assesses behavioral aspects of executive function. Items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Secondary

MeasureTime frameDescription
Change From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksBaseline and up to 10 weeksThe AIM-A was developed to assess impact of core ADHD symptoms on daily functioning and quality of life. For multi-item scales, subjects respond to items using a Likert scale with responses ranging from 1 (strongly agree) to 5 (strongly disagree). Scores were computed by deriving the mean of the item sets and transforming the scale score on a continuum from 0 to 100 using a standard formula. Higher scores indicate a better quality of life.
Change From Baseline in Informant-reported BRIEF-A T-scores at up to 10 WeeksBaseline and up to10 weeksBRIEF-A is a validated 75-item questionnaire composed of three indexes (Global Executive Composite, Behavioral Recognition Index, and Metacognition Index). Items are rated 1 (never), 2 (sometimes), and 3 (often). Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.
Change From Baseline in Subject-reported BRIEF-A T-scores at up to 10 WeeksBaseline and up to 10 weeksBRIEF-A is a validated 75-item questionnaire composed of three indexes (Global Executive Composite, Behavioral Recognition Index, and Metacognition Index). Global Executive Composite was reported as the Primary Outcome. Items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.
Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksBaseline and up to 10 weeksBRIEF-A clinical subscales items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.
Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksBaseline and up to 10 weeksBRIEF-A clinical subscales items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.
Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineBaselineCGI-S assesses the severity of the subject's condition on a 7-point scale ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill)
Change From Baseline in Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) With Adult Prompts Total Score at up to 10 WeeksBaseline and up to 10 weeksThe ADHD-RS 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. Lower scores indicate reduction in symptoms.
Percent of Participants With Improvement on Clinical Global Impression - Global Improvement (CGI-I) at up to 10 WeeksUp to 10 weeks post-doseClinical Global Impression-Improvement (CGI-I) consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement is defined as a score of 1 (very much improved) or 2 (much improved) on the scale.
Change From Baseline in AIM-A Multi-Item Scales of Living With ADHD and General Well-being Score at up to 10 WeeksBaseline and up to 10 weeksThe AIM-A was developed to assess impact of core ADHD symptoms on daily functioning and quality of life. For multi-item scales, subjects respond to items using a Likert scale with responses ranging from 1 (strongly agree) to 5 (strongly disagree). Scores were computed by deriving the mean of the item sets and transforming the scale score on a continuum from 0 to 100 using a standard formula. Higher scores indicate a better quality of life.
Change From Baseline in AIM-A Quality of Life Questions 1 and 4 Scores at up to 10 WeeksBaseline and up to 10 weeksQuestion 1: 'On a scale of 1 to 10, how would you rate the overall quality of life right now?' It is rated on a scale of 1 (worst) to 10 (best). Higher scores representing a more positive rating. Question 4: 'How much do you agree with this statement: Over the past few weeks, I've had more good days than bad days?' This is rated on a scale of 1 (strongly agree) to 5 (strongly disagree). Lower scores represent better quality of life.
Change From Baseline in Conner's Adult ADHD Rating Scale-Observer: Short Version (CAARS-O:S) ADHD Index T-score at up to 10 WeeksBaseline and up to 10 weeksThe CAARS-O:S is an assessment tool with prompts provided to an observer who describes ADHD-related symptoms in an adult subject. The 26-item scale is scored on a 4-point scale from 0 (not at all) to 3 (very much, very frequently). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.
Change From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksBaseline and up to 10 weeksThe CAARS-O:S is an assessment tool with prompts provided to an observer who describes ADHD-related symptoms in an adult subject. The 26-item scale is scored on a 4-point scale from 0 (not at all) to 3 (very much, very frequently). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.
Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksBaseline and up to 10 weeksAAQoL is a validated 29-item scale consisting of 4 subscales. The AAQoL yields a total score and 4 subscale scores. Subjects rate each item on a 5-point Likert scale ranging from 1 (not at all/never) to 5 (extremely/very often). These scores are then transformed to a 0-100 point scale with higher scores indicating better quality of life.
Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksUp to 10 weeks post-doseCGI-S assesses the severity of the subject's condition on a 7-point scale ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill)

Countries

United States

Participant flow

Pre-assignment details

161 subjects were enrolled and randomized, but 2 never received any investigational product, and therefore were not included in subject disposition going forward (n = 159).

Participants by arm

ArmCount
SPD489
Dosed orally once a day at approximately 7:00 AM at either 30, 50 or 70 mg for 10 weeks (a 4-week dose optimization period followed by a 6-week dose maintenance period at an optimal dose).
79
Placebo
Dosed orally once a day at approximately 7:00 AM for 10 weeks.
80
Total159

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event62
Overall StudyLack of Efficacy07
Overall StudyLost to Follow-up14
Overall StudyNon-compliance10
Overall StudyProtocol Violation43
Overall StudySponsor decision11
Overall StudyVacation01
Overall StudyWithdrawal by Subject38
Overall StudyWork schedule11

Baseline characteristics

CharacteristicPlaceboSPD489Total
Age, Continuous34.9 years
STANDARD_DEVIATION 11.02
34.2 years
STANDARD_DEVIATION 10.58
34.6 years
STANDARD_DEVIATION 10.77
Age, Customized
18 to 55 years
80 Participants79 Participants159 Participants
Age, Customized
<18 years
0 Participants0 Participants0 Participants
Age, Customized
>55 years
0 Participants0 Participants0 Participants
Region of Enrollment
United States
80 Participants79 Participants159 Participants
Sex: Female, Male
Female
37 Participants39 Participants76 Participants
Sex: Female, Male
Male
43 Participants40 Participants83 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
62 / 7941 / 80
serious
Total, serious adverse events
0 / 790 / 80

Outcome results

Primary

Change From Baseline in Subject-reported Behavior Rating Inventory of Executive Function - Adult Version Global Executive Composite T-score (BRIEF-A GEC T) at up to 10 Weeks

BRIEF-A Global Executive Composite assesses behavioral aspects of executive function. Items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Time frame: Baseline and up to 10 weeks

Population: Full Analysis Set (FAS) defined as all subjects who took 1 dose of investigational product in the double-blind evaluation phase and had 1 primary efficacy assessment.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Subject-reported Behavior Rating Inventory of Executive Function - Adult Version Global Executive Composite T-score (BRIEF-A GEC T) at up to 10 Weeks-22.3 T-scoresStandard Error 1.67
PlaceboChange From Baseline in Subject-reported Behavior Rating Inventory of Executive Function - Adult Version Global Executive Composite T-score (BRIEF-A GEC T) at up to 10 Weeks-11.1 T-scoresStandard Error 1.72
p-value: <0.000195% CI: [-15.9, -6.4]ANCOVA
Secondary

Change From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 Weeks

The AIM-A was developed to assess impact of core ADHD symptoms on daily functioning and quality of life. For multi-item scales, subjects respond to items using a Likert scale with responses ranging from 1 (strongly agree) to 5 (strongly disagree). Scores were computed by deriving the mean of the item sets and transforming the scale score on a continuum from 0 to 100 using a standard formula. Higher scores indicate a better quality of life.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksPerformance and Daily Functioning38.8 Scores on a scaleStandard Error 2.84
SPD489Change From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksImpact of symptoms: Daily Interference30.6 Scores on a scaleStandard Error 2.52
SPD489Change From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksImpact of symptoms: Bother/Concern29.3 Scores on a scaleStandard Error 2.53
SPD489Change From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksRelationships/Communication21.2 Scores on a scaleStandard Error 2.49
PlaceboChange From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksRelationships/Communication13.4 Scores on a scaleStandard Error 2.56
PlaceboChange From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksPerformance and Daily Functioning17.2 Scores on a scaleStandard Error 2.91
PlaceboChange From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksImpact of symptoms: Bother/Concern15.8 Scores on a scaleStandard Error 2.6
PlaceboChange From Baseline in Adult ADHD Impact Module (AIM-A) Multi-Item Scales Total Score at up to 10 WeeksImpact of symptoms: Daily Interference15.7 Scores on a scaleStandard Error 2.58
Comparison: Performance and Daily Functioningp-value: <0.000195% CI: [13.5, 29.7]ANCOVA
Comparison: Daily Interferencep-value: <0.000195% CI: [7.8, 22]ANCOVA
Comparison: Bother/Concernp-value: 0.000395% CI: [6.3, 20.7]ANCOVA
Comparison: Relationships/Communicationp-value: 0.030295% CI: [0.8, 14.9]ANCOVA
Secondary

Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 Weeks

AAQoL is a validated 29-item scale consisting of 4 subscales. The AAQoL yields a total score and 4 subscale scores. Subjects rate each item on a 5-point Likert scale ranging from 1 (not at all/never) to 5 (extremely/very often). These scores are then transformed to a 0-100 point scale with higher scores indicating better quality of life.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksPsychological Health19.3 Scores on a scaleStandard Error 3.61
SPD489Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksRelationships17.1 Scores on a scaleStandard Error 3.69
SPD489Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksLife Outlook18.5 Scores on a scaleStandard Error 2.85
SPD489Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksTotal Score25.9 Scores on a scaleStandard Error 3.04
SPD489Change From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksLife Productivity38.0 Scores on a scaleStandard Error 4.34
PlaceboChange From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksTotal Score11.1 Scores on a scaleStandard Error 3.16
PlaceboChange From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksLife Productivity17.0 Scores on a scaleStandard Error 4.51
PlaceboChange From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksPsychological Health7.2 Scores on a scaleStandard Error 3.74
PlaceboChange From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksLife Outlook6.0 Scores on a scaleStandard Error 2.96
PlaceboChange From Baseline in Adult ADHD Quality of Life (AAQoL) Scale Total Score at up to 10 WeeksRelationships9.8 Scores on a scaleStandard Error 3.83
Comparison: Life Productivityp-value: 0.001695% CI: [8.4, 33.6]ANCOVA
Comparison: Psychological Healthp-value: 0.024295% CI: [1.6, 22.5]ANCOVA
Comparison: Life Outlookp-value: 0.003895% CI: [4.2, 20.8]ANCOVA
Comparison: Relationshipsp-value: 0.175295% CI: [-3.4, 18]ANCOVA
Comparison: Total Scorep-value: 0.001595% CI: [5.9, 23.6]ANCOVA
Secondary

Change From Baseline in AIM-A Multi-Item Scales of Living With ADHD and General Well-being Score at up to 10 Weeks

The AIM-A was developed to assess impact of core ADHD symptoms on daily functioning and quality of life. For multi-item scales, subjects respond to items using a Likert scale with responses ranging from 1 (strongly agree) to 5 (strongly disagree). Scores were computed by deriving the mean of the item sets and transforming the scale score on a continuum from 0 to 100 using a standard formula. Higher scores indicate a better quality of life.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in AIM-A Multi-Item Scales of Living With ADHD and General Well-being Score at up to 10 WeeksLiving with ADHD14.0 Scores on a scaleStandard Error 1.3
SPD489Change From Baseline in AIM-A Multi-Item Scales of Living With ADHD and General Well-being Score at up to 10 WeeksGeneral Well-being19.7 Scores on a scaleStandard Error 1.69
PlaceboChange From Baseline in AIM-A Multi-Item Scales of Living With ADHD and General Well-being Score at up to 10 WeeksLiving with ADHD4.9 Scores on a scaleStandard Error 1.33
PlaceboChange From Baseline in AIM-A Multi-Item Scales of Living With ADHD and General Well-being Score at up to 10 WeeksGeneral Well-being9.0 Scores on a scaleStandard Error 1.73
Comparison: Living with ADHDp-value: <0.000195% CI: [5.4, 12.7]ANCOVA
Comparison: General Well-beingp-value: <0.000195% CI: [6, 15.5]ANCOVA
Secondary

Change From Baseline in AIM-A Quality of Life Questions 1 and 4 Scores at up to 10 Weeks

Question 1: 'On a scale of 1 to 10, how would you rate the overall quality of life right now?' It is rated on a scale of 1 (worst) to 10 (best). Higher scores representing a more positive rating. Question 4: 'How much do you agree with this statement: Over the past few weeks, I've had more good days than bad days?' This is rated on a scale of 1 (strongly agree) to 5 (strongly disagree). Lower scores represent better quality of life.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in AIM-A Quality of Life Questions 1 and 4 Scores at up to 10 WeeksQuestion 11.6 Scores on a scaleStandard Error 0.16
SPD489Change From Baseline in AIM-A Quality of Life Questions 1 and 4 Scores at up to 10 WeeksQuestion 4-1.0 Scores on a scaleStandard Error 0.11
PlaceboChange From Baseline in AIM-A Quality of Life Questions 1 and 4 Scores at up to 10 WeeksQuestion 11.0 Scores on a scaleStandard Error 0.16
PlaceboChange From Baseline in AIM-A Quality of Life Questions 1 and 4 Scores at up to 10 WeeksQuestion 4-0.4 Scores on a scaleStandard Error 0.11
Comparison: Question 1p-value: 0.018495% CI: [0.1, 1]ANCOVA
Comparison: Question 4p-value: 0.000495% CI: [-0.9, -0.3]ANCOVA
Secondary

Change From Baseline in Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) With Adult Prompts Total Score at up to 10 Weeks

The ADHD-RS 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. Lower scores indicate reduction in symptoms.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) With Adult Prompts Total Score at up to 10 Weeks-21.4 Scores on a scaleStandard Error 1.35
PlaceboChange From Baseline in Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) With Adult Prompts Total Score at up to 10 Weeks-10.3 Scores on a scaleStandard Error 1.38
p-value: <0.000195% CI: [-14.9, -7.3]ANCOVA
Secondary

Change From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 Weeks

The CAARS-O:S is an assessment tool with prompts provided to an observer who describes ADHD-related symptoms in an adult subject. The 26-item scale is scored on a 4-point scale from 0 (not at all) to 3 (very much, very frequently). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksInattention/Memory Problems-10.0 T-scoresStandard Error 1.12
SPD489Change From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksHyperactivity/Restlessness-9.1 T-scoresStandard Error 1.2
SPD489Change From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksImpulsivity/Emotional Liability-8.0 T-scoresStandard Error 1.01
SPD489Change From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksProblems with Self-concept-7.7 T-scoresStandard Error 1.1
PlaceboChange From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksProblems with Self-concept-3.3 T-scoresStandard Error 1.1
PlaceboChange From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksInattention/Memory Problems-4.9 T-scoresStandard Error 1.12
PlaceboChange From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksImpulsivity/Emotional Liability-4.0 T-scoresStandard Error 1.01
PlaceboChange From Baseline in CAARS-O:S Factor-derived Subscale T-scores at up to 10 WeeksHyperactivity/Restlessness-5.0 T-scoresStandard Error 1.2
Comparison: Inattention/Memory Problemsp-value: 0.001795% CI: [-8.2, -1.9]ANCOVA
Comparison: Hyperactivity/Restlessnessp-value: 0.017495% CI: [-7.5, -0.7]ANCOVA
Comparison: Impulsivity/Emotional Liabilityp-value: 0.006395% CI: [-6.8, -1.1]ANCOVA
Comparison: Problems with Self-conceptp-value: 0.005995% CI: [-7.5, -1.3]ANCOVA
Secondary

Change From Baseline in Conner's Adult ADHD Rating Scale-Observer: Short Version (CAARS-O:S) ADHD Index T-score at up to 10 Weeks

The CAARS-O:S is an assessment tool with prompts provided to an observer who describes ADHD-related symptoms in an adult subject. The 26-item scale is scored on a 4-point scale from 0 (not at all) to 3 (very much, very frequently). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Conner's Adult ADHD Rating Scale-Observer: Short Version (CAARS-O:S) ADHD Index T-score at up to 10 Weeks-11.3 T-scoresStandard Error 1.24
PlaceboChange From Baseline in Conner's Adult ADHD Rating Scale-Observer: Short Version (CAARS-O:S) ADHD Index T-score at up to 10 Weeks-5.8 T-scoresStandard Error 1.24
p-value: 0.001995% CI: [-9, -2.1]ANCOVA
Secondary

Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 Weeks

BRIEF-A clinical subscales items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksShift-9.1 T-scoresStandard Error 1.17
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksWorking memory-12.0 T-scoresStandard Error 1.22
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksSelf-monitor-6.8 T-scoresStandard Error 1.04
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksPlan/Organize-9.9 T-scoresStandard Error 1.07
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksEmotional control-5.9 T-scoresStandard Error 0.99
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksTask monitor-9.7 T-scoresStandard Error 1.21
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInitiate-8.6 T-scoresStandard Error 1
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksOrganization of materials-6.2 T-scoresStandard Error 0.97
SPD489Change From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInhibit-10.2 T-scoresStandard Error 1.08
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksOrganization of materials-3.0 T-scoresStandard Error 0.97
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInhibit-5.8 T-scoresStandard Error 1.08
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksShift-4.3 T-scoresStandard Error 1.17
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksEmotional control-4.6 T-scoresStandard Error 0.99
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksSelf-monitor-4.6 T-scoresStandard Error 1.04
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInitiate-3.2 T-scoresStandard Error 1
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksWorking memory-5.7 T-scoresStandard Error 1.22
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksPlan/Organize-5.0 T-scoresStandard Error 1.07
PlaceboChange From Baseline in Informant-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksTask monitor-3.4 T-scoresStandard Error 1.21
Comparison: Inhibitp-value: 0.004895% CI: [-7.4, -1.4]ANCOVA
Comparison: Shiftp-value: 0.004595% CI: [-8, -1.5]ANCOVA
Comparison: Emotional controlp-value: 0.360595% CI: [-4, 1.5]ANCOVA
Comparison: Self-monitorp-value: 0.146895% CI: [-5.1, 0.8]ANCOVA
Comparison: Initiatep-value: 0.000295% CI: [-8.3, -2.7]ANCOVA
Comparison: Working memoryp-value: 0.000495% CI: [-9.8, -2.9]ANCOVA
Comparison: Plan/Organizep-value: 0.001595% CI: [-7.9, -1.9]ANCOVA
Comparison: Task monitorp-value: 0.000395% CI: [-9.7, -2.9]ANCOVA
Comparison: Organization of materialsp-value: 0.023495% CI: [-5.9, -0.4]ANCOVA
Secondary

Change From Baseline in Informant-reported BRIEF-A T-scores at up to 10 Weeks

BRIEF-A is a validated 75-item questionnaire composed of three indexes (Global Executive Composite, Behavioral Recognition Index, and Metacognition Index). Items are rated 1 (never), 2 (sometimes), and 3 (often). Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Time frame: Baseline and up to10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Informant-reported BRIEF-A T-scores at up to 10 WeeksGlobal Executive Composite-10.2 T-scoresStandard Error 1.06
SPD489Change From Baseline in Informant-reported BRIEF-A T-scores at up to 10 WeeksBehavioral Regulation Index-8.6 T-scoresStandard Error 1.04
SPD489Change From Baseline in Informant-reported BRIEF-A T-scores at up to 10 WeeksMetacognition Index-10.3 T-scoresStandard Error 1.07
PlaceboChange From Baseline in Informant-reported BRIEF-A T-scores at up to 10 WeeksGlobal Executive Composite-5.3 T-scoresStandard Error 1.06
PlaceboChange From Baseline in Informant-reported BRIEF-A T-scores at up to 10 WeeksBehavioral Regulation Index-5.5 T-scoresStandard Error 1.04
PlaceboChange From Baseline in Informant-reported BRIEF-A T-scores at up to 10 WeeksMetacognition Index-4.6 T-scoresStandard Error 1.07
Comparison: Global Executive Compositep-value: 0.001695% CI: [-7.8, -1.9]ANCOVA
Comparison: Behavioral Regulation Indexp-value: 0.035595% CI: [-6, -0.2]ANCOVA
Comparison: Metacognition Indexp-value: 0.000395% CI: [-8.7, -2.7]ANCOVA
Secondary

Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 Weeks

BRIEF-A clinical subscales items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksShift-14.5 T-scoresStandard Error 1.46
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksWorking memory-23.2 T-scoresStandard Error 1.67
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksSelf-monitor-16.6 T-scoresStandard Error 1.44
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksPlan/Organize-20.8 T-scoresStandard Error 1.58
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksEmotional control-10.9 T-scoresStandard Error 1.28
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksTask monitor-20.1 T-scoresStandard Error 1.64
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInitiate-17.9 T-scoresStandard Error 1.38
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksOrganization of materials-16.5 T-scoresStandard Error 1.26
SPD489Change From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInhibit-17.8 T-scoresStandard Error 1.5
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksOrganization of materials-7.6 T-scoresStandard Error 1.3
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInhibit-9.5 T-scoresStandard Error 1.54
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksShift-7.8 T-scoresStandard Error 1.5
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksEmotional control-5.7 T-scoresStandard Error 1.31
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksSelf-monitor-8.4 T-scoresStandard Error 1.48
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksInitiate-8.6 T-scoresStandard Error 1.41
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksWorking memory-11.9 T-scoresStandard Error 1.71
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksPlan/Organize-9.9 T-scoresStandard Error 1.62
PlaceboChange From Baseline in Subject-reported BRIEF-A Clinical Subscales T-scores at up to 10 WeeksTask monitor-10.8 T-scoresStandard Error 1.68
Comparison: Inhibitp-value: 0.000195% CI: [-12.6, -4.1]ANCOVA
Comparison: Shiftp-value: 0.001895% CI: [-10.8, -2.5]ANCOVA
Comparison: Emotional controlp-value: 0.005695% CI: [-8.8, -1.5]ANCOVA
Comparison: Sef-monitorp-value: 0.000195% CI: [-12.3, -4.1]ANCOVA
Comparison: Initiatep-value: <0.000195% CI: [-13.2, -5.4]ANCOVA
Comparison: Working memoryp-value: <0.000195% CI: [-16, -6.6]ANCOVA
Comparison: Plan/Organizep-value: <0.000195% CI: [-15.4, -6.4]ANCOVA
Comparison: Task monitorp-value: 0.000195% CI: [-14, -4.7]ANCOVA
Comparison: Organization of materialsp-value: <0.000195% CI: [-12.5, -5.3]ANCOVA
Secondary

Change From Baseline in Subject-reported BRIEF-A T-scores at up to 10 Weeks

BRIEF-A is a validated 75-item questionnaire composed of three indexes (Global Executive Composite, Behavioral Recognition Index, and Metacognition Index). Global Executive Composite was reported as the Primary Outcome. Items are rated 1 (never), 2 (sometimes), and 3 (often). There is no range for a total score. Raw scale scores are used to generate T-scores. A reduction in score indicates less impairment.

Time frame: Baseline and up to 10 weeks

Population: FAS

ArmMeasureGroupValue (MEAN)Dispersion
SPD489Change From Baseline in Subject-reported BRIEF-A T-scores at up to 10 WeeksBehavioral Regulation Index-17.5 T-scoresStandard Error 1.54
SPD489Change From Baseline in Subject-reported BRIEF-A T-scores at up to 10 WeeksMetacognition Index-22.8 T-scoresStandard Error 1.63
PlaceboChange From Baseline in Subject-reported BRIEF-A T-scores at up to 10 WeeksBehavioral Regulation Index-9.2 T-scoresStandard Error 1.58
PlaceboChange From Baseline in Subject-reported BRIEF-A T-scores at up to 10 WeeksMetacognition Index-11.2 T-scoresStandard Error 1.67
Comparison: Behavioral Regulation Indexp-value: 0.000295% CI: [-12.7, -4]ANCOVA
Comparison: Metacognition Indexp-value: <0.000195% CI: [-16.3, -7]ANCOVA
Secondary

Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at Baseline

CGI-S assesses the severity of the subject's condition on a 7-point scale ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill)

Time frame: Baseline

Population: FAS

ArmMeasureGroupValue (NUMBER)
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineMildly ill0 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineMarkedly ill38.0 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineBorderline mentally ill0 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineSeverely ill13.9 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineModerately ill48.1 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineAmong the most extremely ill0 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineNormal, not at all ill0 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineAmong the most extremely ill0 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineNormal, not at all ill0 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineBorderline mentally ill0 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineMildly ill0 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineModerately ill42.7 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineMarkedly ill49.3 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at BaselineSeverely ill8.0 Percent of participants
Secondary

Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 Weeks

CGI-S assesses the severity of the subject's condition on a 7-point scale ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill)

Time frame: Up to 10 weeks post-dose

Population: FAS

ArmMeasureGroupValue (NUMBER)
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksMildly ill21.5 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksMarkedly ill8.9 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksBorderline mentally ill38.0 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksSeverely ill2.5 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksModerately ill15.2 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksAmong the most extremely ill0 Percent of participants
SPD489Percent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksNormal, not at all ill13.9 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksAmong the most extremely ill0 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksNormal, not at all ill6.7 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksBorderline mentally ill16.0 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksMildly ill10.7 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksModerately ill37.3 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksMarkedly ill25.3 Percent of participants
PlaceboPercent of Participants With Clinical Global Impression - Severity of Illness (CGI-S) at up to 10 WeeksSeverely ill4.0 Percent of participants
Secondary

Percent of Participants With Improvement on Clinical Global Impression - Global Improvement (CGI-I) at up to 10 Weeks

Clinical Global Impression-Improvement (CGI-I) consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement is defined as a score of 1 (very much improved) or 2 (much improved) on the scale.

Time frame: Up to 10 weeks post-dose

Population: FAS

ArmMeasureValue (NUMBER)
SPD489Percent of Participants With Improvement on Clinical Global Impression - Global Improvement (CGI-I) at up to 10 Weeks78.5 Percent of participants
PlaceboPercent of Participants With Improvement on Clinical Global Impression - Global Improvement (CGI-I) at up to 10 Weeks34.7 Percent of participants
p-value: <0.0001Chi-squared

Source: ClinicalTrials.gov · Data processed: Mar 22, 2026