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Acamprosate in Youth With Fragile X Syndrome

Pilot Study of Acamprosate in Youth With Fragile X Syndrome

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01300923
Enrollment
14
Registered
2011-02-23
Start date
2010-08-31
Completion date
2011-09-30
Last updated
2019-07-30

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

Conditions

Autism Spectrum Disorders, Fragile X Syndrome

Keywords

Fragile X Syndrome, Acamprosate

Brief summary

Fragile X syndrome (FXS) is the most common inherited form of developmental disability. FXS is inherited from the carrier parent, most often the mothers. FXS is associated with severe interfering behavioral symptoms which include anxiety related symptoms, attention deficit hyperactivity, and aggressive behaviors. Approximately 25-33% of individuals with FXS also meet criteria for autistic disorder. The hypothesis of this study is that treatment with acamprosate will reduce inattention/hyperactivity, language impairment, irritability, social deficits, and cognitive delay in youth with FXS. The purpose of this study is to investigate the effectiveness and tolerability of acamprosate in youth with Fragile X Syndrome and to assess the potential psychophysiological differences between FXS and autism spectrum disorders.

Interventions

DRUGAcamprosate

Sponsors

Indiana University
Lead SponsorOTHER

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
5 Years to 17 Years
Healthy volunteers
No

Inclusion criteria

* Male and female outpatients between the ages of 5 and 17 years. * Confirmed diagnosis of Fragile X Syndrome based upon genetic testing. * Stable dosing of all psychotropic medications for at least 2 weeks prior to baseline. * Subjects with a stable seizure disorder or history of only childhood febrile seizures will be included. * Clinical Global Impression-Severity Score of 4 (Moderately Ill) or greater. * Must be in good physical health. * Subjects of child bearing age of both genders will be required to utilize birth control as applicable.

Exclusion criteria

* Diagnosis of schizophrenia, another psychotic disorder, bipolar disorder or alcohol or other substance abuse based on Diagnostic and Statistical Manual Fourth Edition-Text Revised (DSM-IV-TR). * A significant medical condition such as heart, liver, renal or pulmonary disease or unstable seizure disorder. * Females with a positive urine pregnancy test * Creatinine clearance of less than 30. * Concomitant use of another glutamatergic agent (memantine,riluzole, d-cycloserine, amantadine topiramate, gabapentin, among others. * Evidence of hypersensitivity to acamprosate or potentially serious adverse effect. * Subjects who, in the opinion of the investigator, are unsuitable in any other way to participate in this study including being unable to comply with the requirements of the study for any reason.

Design outcomes

Primary

MeasureTime frameDescription
Clinical Global Impression- Severity Scale (CGI-S)Week 10The 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.

Secondary

MeasureTime frameDescription
Social Responsiveness ScaleWeek 10The 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
Children's Yale-Brown Obsessive Compulsive Scale Modified for PDDWeek 10The Children's Yale-Brown Obsessive Compulsive Scales-Modified (CY-BOCS) is a 5-item, semi-structured clinician rating scale modified designed to rate the current severity of repetitive behavior in children and adolescents with PDD. Once the current repetitive behaviors are identified, they are separately rated on 5 items: Time Spent, Interference, Distress, Resistance, and Control. Each of these items is scored on a 5-point scale form 0 (least symptomatic) to 4 (most symptomatic). The CY-BOCS yields a Total Score from 0 to 20 and is sensitive to change.
ADHD Rating Scale 4th EditionWeek 10The 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.
The Aberrant Behavior Checklist (ABC)Week 10The Aberrant Behavior Checklist (ABC) is a 58-item rating scale used to assess maladaptive behaviors across five original subscales: Irritability (15 items from 0-45), Social Withdrawal (16 items from 0-48), Stereotypy (7 items from 0-21), Hyperactivity (16 items from 0-48), Inappropriate Speech (4 items from 0-12). Additionally, Social Avoidance, a newly developed four-item subscale (from 0-12) of the ABC that captures core social avoidance aspects of Fragile X Syndrome is reported. All items on the ABC are rated from 0 (not at all a problem) to 3 (the problem is severe in degree). Higher scores indicate greater maladaptive behaviors. Differences between Baseline and Week 10 are used as an indicator of change.
Peabody Picture VocabularyWeek 10The 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.
Brain-derived Neurotrophic Factor (BDNF)Screen and Week 10BDNF is a protein that supports the survival of existing neurons and growth and differentiation of new neurons and synapses.
Vineland Adaptive Behavior Scales-II (VABS-II) Communication DomainWeek 10The VABS-II is a semi-structured interview designed to assess adaptive functioning in communication, daily living, socialization and motor skills. Recognizing that language is a major area of impairment in the study population, the Communication Domain (99 Items from 0-198), in particular the Expressive Subdomain (54 Items from 0-108) are of interest in this study. Items arranged in a developmental sequence are rated on a 3-point scale. Each item is scored from 0 (never performs the behavior) to 3 (usually performs the behavior independently). Higher scores indicate higher adaptive functioning. Differences between Baseline and Week 10 are used as an indicator of change.

Countries

United States

Participant flow

Pre-assignment details

The psychophysiological measures proved non-feasible as subjects could not tolerate the procedures. The paradigms were tried on two subjects in the Autism Spectrum Disorder arm; however, the data that was collected was not usable. Subsequently, neurobiological characterization was halted.

Participants by arm

ArmCount
Acamprosate Treatment Group
Twelve subjects received open-label acamprosate, mean final of 1,054 mg/day (range: 666-1,998 mg/day)
12
Total12

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyPhysician Decision02

Baseline characteristics

CharacteristicAcamprosate Treatment Group
Aberrant Behavior Checklist
ABC Hyperactivity
16.8 units on a scale
STANDARD_DEVIATION 9.1
Aberrant Behavior Checklist
ABC Inappropriate Speech
5.2 units on a scale
STANDARD_DEVIATION 3.5
Aberrant Behavior Checklist
ABC Irritability
9.9 units on a scale
STANDARD_DEVIATION 7.8
Aberrant Behavior Checklist
ABC Social Avoidance
3.3 units on a scale
STANDARD_DEVIATION 2.6
Aberrant Behavior Checklist
ABC Social Withdrawal
8.8 units on a scale
STANDARD_DEVIATION 5.8
Aberrant Behavior Checklist
ABC Stereotypy
6.8 units on a scale
STANDARD_DEVIATION 6.8
ADHD Rating Scale 4th Edition23.6 units on a scale
STANDARD_DEVIATION 10.6
Age, Categorical
<=18 years
12 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
Age, Continuous11.9 years
Brain-derived neurotropic factor790.4 pg/mL
STANDARD_DEVIATION 1.305
Children's Yale-Brown Obsessive Compulsive Scale Modified for PDD11.1 units on a scale
STANDARD_DEVIATION 2.6
Clinical Global Impression -Severity4.25 units on a scale
STANDARD_DEVIATION 0.45
Peabody Picture Vocabulary Test85.2 units on a scale
STANDARD_DEVIATION 32
Region of Enrollment
United States
12 participants
Sex: Female, Male
Female
2 Participants
Sex: Female, Male
Male
10 Participants
Social Responsiveness Scale91.3 units on a scale
STANDARD_DEVIATION 27.4
Vineland Adaptive Behavior Scales-II (VABS-II) Communication Domain
Communication Domain
63.4 units on a scale
STANDARD_DEVIATION 10
Vineland Adaptive Behavior Scales-II (VABS-II) Communication Domain
Expressive Communication Domain
69.8 units on a scale
STANDARD_DEVIATION 23

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
9 / 12
serious
Total, serious adverse events
0 / 12

Outcome results

Primary

Clinical Global Impression- Severity Scale (CGI-S)

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 10

ArmMeasureValue (MEAN)Dispersion
Acamprosate Treatment GroupClinical Global Impression- Severity Scale (CGI-S)7.0 units on a scaleStandard Deviation 8.9
Secondary

ADHD Rating Scale 4th Edition

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 10

ArmMeasureValue (MEAN)Dispersion
Acamprosate Treatment GroupADHD Rating Scale 4th Edition16.7 units on a scaleStandard Deviation 8
Secondary

Brain-derived Neurotrophic Factor (BDNF)

BDNF is a protein that supports the survival of existing neurons and growth and differentiation of new neurons and synapses.

Time frame: Screen and Week 10

ArmMeasureValue (MEAN)
Acamprosate Treatment GroupBrain-derived Neurotrophic Factor (BDNF)1,007.6 pg/mL
Secondary

Children's Yale-Brown Obsessive Compulsive Scale Modified for PDD

The Children's Yale-Brown Obsessive Compulsive Scales-Modified (CY-BOCS) is a 5-item, semi-structured clinician rating scale modified designed to rate the current severity of repetitive behavior in children and adolescents with PDD. Once the current repetitive behaviors are identified, they are separately rated on 5 items: Time Spent, Interference, Distress, Resistance, and Control. Each of these items is scored on a 5-point scale form 0 (least symptomatic) to 4 (most symptomatic). The CY-BOCS yields a Total Score from 0 to 20 and is sensitive to change.

Time frame: Week 10

ArmMeasureValue (MEAN)Dispersion
Acamprosate Treatment GroupChildren's Yale-Brown Obsessive Compulsive Scale Modified for PDD9.8 units on a scaleStandard Deviation 4.1
Secondary

Peabody Picture Vocabulary

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 10

ArmMeasureValue (MEAN)Dispersion
Acamprosate Treatment GroupPeabody Picture Vocabulary83.3 units on a scaleStandard Deviation 32
Secondary

Social Responsiveness 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 10

ArmMeasureValue (MEAN)Dispersion
Acamprosate Treatment GroupSocial Responsiveness Scale76.4 units on a scaleStandard Deviation 26.8
Secondary

The Aberrant Behavior Checklist (ABC)

The Aberrant Behavior Checklist (ABC) is a 58-item rating scale used to assess maladaptive behaviors across five original subscales: Irritability (15 items from 0-45), Social Withdrawal (16 items from 0-48), Stereotypy (7 items from 0-21), Hyperactivity (16 items from 0-48), Inappropriate Speech (4 items from 0-12). Additionally, Social Avoidance, a newly developed four-item subscale (from 0-12) of the ABC that captures core social avoidance aspects of Fragile X Syndrome is reported. All items on the ABC are rated from 0 (not at all a problem) to 3 (the problem is severe in degree). Higher scores indicate greater maladaptive behaviors. Differences between Baseline and Week 10 are used as an indicator of change.

Time frame: Week 10

ArmMeasureGroupValue (MEAN)Dispersion
Acamprosate Treatment GroupThe Aberrant Behavior Checklist (ABC)ABC Irritability7.0 units on a scaleStandard Deviation 8.9
Acamprosate Treatment GroupThe Aberrant Behavior Checklist (ABC)ABC Social Withdrawal4.1 units on a scaleStandard Deviation 6.5
Acamprosate Treatment GroupThe Aberrant Behavior Checklist (ABC)ABC Stereotypy6.0 units on a scaleStandard Deviation 6.3
Acamprosate Treatment GroupThe Aberrant Behavior Checklist (ABC)ABC Hyperactivity11.0 units on a scaleStandard Deviation 8.6
Acamprosate Treatment GroupThe Aberrant Behavior Checklist (ABC)ABC Inappropriate Speech4.8 units on a scaleStandard Deviation 3.4
Acamprosate Treatment GroupThe Aberrant Behavior Checklist (ABC)ABC Social Avoidance1.6 units on a scaleStandard Deviation 2.7
Secondary

Vineland Adaptive Behavior Scales-II (VABS-II) Communication Domain

The VABS-II is a semi-structured interview designed to assess adaptive functioning in communication, daily living, socialization and motor skills. Recognizing that language is a major area of impairment in the study population, the Communication Domain (99 Items from 0-198), in particular the Expressive Subdomain (54 Items from 0-108) are of interest in this study. Items arranged in a developmental sequence are rated on a 3-point scale. Each item is scored from 0 (never performs the behavior) to 3 (usually performs the behavior independently). Higher scores indicate higher adaptive functioning. Differences between Baseline and Week 10 are used as an indicator of change.

Time frame: Week 10

ArmMeasureGroupValue (MEAN)Dispersion
Acamprosate Treatment GroupVineland Adaptive Behavior Scales-II (VABS-II) Communication DomainCommunication Domain66.6 units on a scaleStandard Deviation 11.2
Acamprosate Treatment GroupVineland Adaptive Behavior Scales-II (VABS-II) Communication DomainExpressive Communication78.9 units on a scaleStandard Deviation 21.2

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