Attention Deficit Hyperactivity Disorder (ADHD)
Conditions
Brief summary
This is a randomized, double-blind, placebo-controlled, parallel group, Phase 3 trial to evaluate the safety and efficacy of NT0102 in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric patients 6 to 12 years of age in a laboratory classroom study.
Interventions
NT0102 (methylphenidate polistirex \[MPP\] extended release \[XR\] ODT) was given once daily at a dose equivalent to 20-60 mg methylphenidate hydrochloride.
Matching ODT placebo was given once daily.
Sponsors
Study design
Eligibility
Inclusion criteria
* Currently being treated for ADHD
Exclusion criteria
* Other psychiatric diagnoses * Significant cognitive impairment * Chronic medical illnesses * Structural cardiac defects * Significant abnormal lab tests * Taking disallowed medications * Positive drug test
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) Score | Visit 8 (Day 42) | The primary efficacy endpoint was derived from the SKAMP-Combined score calculated as the total score of all 13 items of the SKAMP-Combined score. The SKAMP-Combined score was obtained by summing up each item score where each item is rated on a 7-point impairment scale (0=normal to 6=maximal impairment) for a total possible score of 0 to 78. A lower score indicates less symptomatology (i.e., is better). The SKAMP was a rating scale that specifically measures the classroom manifestations of ADHD. The SKAMP ratings were completed for all subjects at baseline (pre-dose) and at 1, 3, 5, 7, 10, 12, and 13 hours post-dose on the classroom testing day (Visit 8). The primary analysis time point for the primary efficacy endpoint was the average of all post-dose SKAMP scores during the 13-hour period. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Effect | Visit 8 (Day 42) at 1 hour (h), 3 h, 5 h, 7 h, 10 h, 12 h and 13 h | Duration of effect was defined as the last time point at which NT0102 separates from placebo on SKAMP-Combined scores. A separation was defined as a statistically significant difference at the 5% level of active drug over placebo. Data was collected separately for NT0102 and Placebo arms, and is reported as a comparison analysis of the two arms. This assessment was collected on the full classroom day, Visit 8. |
| The Average of the SKAMP-Attention Scores | Visit 8 (Day 42) | The SKAMP Rating Scale was comprised of 2 behavioral subscales, including the Attention subscale (4 items). The SKAMP-Attention subscore evaluates concentration in the classroom and is obtained by summing up each item score where each item is rated on a 7-point impairment scale (0=normal to 6=maximal impairment) for total possible combined score of 0 to 24. A lower score indicates less symptomatology (i.e. is better). The SKAMP-Attention subscores were derived from 20 minutes of direct observations of participant behavior. Ratings were based on the frequency and quality of behaviors. |
| The Average of the SKAMP-Deportment Scores | Visit 8 (Day 42) | The SKAMP Rating Scale is comprised of 2 behavioural subscales, including the Deportment subscale (4 items). The SKAMP-Deportment subscore evaluates behaviour in the classroom and is obtained by summing up each item score where each item is rated on a 7-point impairment scale (0=normal to 6=maximal impairment) for total possible combined score of 0 to 24. A lower score indicates less symptomatology (i.e. is better). The SKAMP-Attention subscores were derived from 20 minutes of direct observations of participant behaviour. Ratings were based on the frequency and quality of behaviours. |
| Onset of Effect | Visit 8 (Day 42) at 1 hour (h), 3 h, 5 h, 7 h, 10 h, 12 h and 13 h | Onset of effect was defined as the first time point at which NT0102 separates from placebo on SKAMP-Combined scores. A separation was defined as a statistically significant difference at the 5% level of active drug over placebo. Data was collected separately for NT0102 and Placebo arms and is reported as a comparison analysis of the two arms. This assessment was collected on the full classroom day, Visit 8. |
| The Average of the Permanent Product Measure of Performance - Correct (PERMP-C) Score | Visit 8 (Day 42) | The PERMP consisted of 400 math problems and was graded as number of problems Attempted (PERMP-A) and number of problems Correct. (PERMP-C). It was an objective measure of performance during the classroom testing day. |
| Number of Participants With Adverse Events | Visit 9 (Day 43) | An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events. |
| The Average of the Permanent Product Measure of Performance - Attempted (PERMP-A) Score | Visit 8 (Day 42) | The PERMP consisted of 400 math problems and was graded as number of problems Attempted (PERMP-A) and number of problems Correct. (PERMP-C). It was an objective measure of performance during the classroom testing day. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| NT0102 After the screening/washout period, all participants received study drug NT0102 once daily for 4 weeks during the dose optimization period. After completion of the dose optimization period, the optimized dose of the study drug was selected, and participants were to stay on that dose for 1 week (dose stabilization period). At the end of this period, participants were randomized to a treatment. Participants in this arm were given 20-60 mg of NT0102 as oral disintegrating tablet (ODT) once daily for one week during the double-blind treatment period. | 43 |
| Placebo After the screening/washout period, all participants received study drug NT0102 once daily for 4 weeks during the dose optimization period. After completion of the dose optimization period, the optimized dose of the study drug was selected, and participants were to stay on that dose for 1 week (dose stabilization period). At the end of this period, participants were randomized to a treatment. Participants in this arm were given placebo as matching ODT once daily for one week during the double-blind treatment period. | 39 |
| Total | 82 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Dose Optimization Period | Adverse Event | 0 | 0 | 1 |
| Dose Optimization Period | Withdrawal by Subject | 0 | 0 | 1 |
| Double-Blind Treatment Period | Adverse Event | 0 | 1 | 0 |
| Double-Blind Treatment Period | Withdrawal by Subject | 0 | 1 | 0 |
Baseline characteristics
| Characteristic | NT0102 | Placebo | Total |
|---|---|---|---|
| Age, Continuous | 9.1 years STANDARD_DEVIATION 1.86 | 9.3 years STANDARD_DEVIATION 1.64 | 9.2 years STANDARD_DEVIATION 1.75 |
| Sex: Female, Male Female | 13 Participants | 15 Participants | 28 Participants |
| Sex: Female, Male Male | 30 Participants | 24 Participants | 54 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 87 | 0 / 41 | 0 / 44 |
| other Total, other adverse events | 70 / 87 | 10 / 41 | 11 / 44 |
| serious Total, serious adverse events | 0 / 87 | 0 / 41 | 0 / 44 |
Outcome results
Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) Score
The primary efficacy endpoint was derived from the SKAMP-Combined score calculated as the total score of all 13 items of the SKAMP-Combined score. The SKAMP-Combined score was obtained by summing up each item score where each item is rated on a 7-point impairment scale (0=normal to 6=maximal impairment) for a total possible score of 0 to 78. A lower score indicates less symptomatology (i.e., is better). The SKAMP was a rating scale that specifically measures the classroom manifestations of ADHD. The SKAMP ratings were completed for all subjects at baseline (pre-dose) and at 1, 3, 5, 7, 10, 12, and 13 hours post-dose on the classroom testing day (Visit 8). The primary analysis time point for the primary efficacy endpoint was the average of all post-dose SKAMP scores during the 13-hour period.
Time frame: Visit 8 (Day 42)
Population: The full analysis set (FAS) consisted of all participants randomized to treatment who had at least 1 post-dose SKAMP-Combined treatment assessment during the classroom testing session on Visit 8. Participants were analyzed as randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) Score | 24.3 score on a scale | Standard Deviation 9.47 |
| NT0102 | Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) Score | 17.3 score on a scale | Standard Deviation 7.48 |
Duration of Effect
Duration of effect was defined as the last time point at which NT0102 separates from placebo on SKAMP-Combined scores. A separation was defined as a statistically significant difference at the 5% level of active drug over placebo. Data was collected separately for NT0102 and Placebo arms, and is reported as a comparison analysis of the two arms. This assessment was collected on the full classroom day, Visit 8.
Time frame: Visit 8 (Day 42) at 1 hour (h), 3 h, 5 h, 7 h, 10 h, 12 h and 13 h
Population: FAS consisted of all participants randomized to treatment who had at least 1 post-dose SKAMP-Combined treatment assessment during the classroom testing session on Visit 8. Participants were analyzed as randomized.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo | Duration of Effect | 12 hour |
Number of Participants With Adverse Events
An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
Time frame: Visit 9 (Day 43)
Population: The safety population included all participants who took at least 1 dose of study drug.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Placebo | Number of Participants With Adverse Events | 70 Participants |
| NT0102 | Number of Participants With Adverse Events | 10 Participants |
| Double-Blind Phase: NT0102 | Number of Participants With Adverse Events | 11 Participants |
Onset of Effect
Onset of effect was defined as the first time point at which NT0102 separates from placebo on SKAMP-Combined scores. A separation was defined as a statistically significant difference at the 5% level of active drug over placebo. Data was collected separately for NT0102 and Placebo arms and is reported as a comparison analysis of the two arms. This assessment was collected on the full classroom day, Visit 8.
Time frame: Visit 8 (Day 42) at 1 hour (h), 3 h, 5 h, 7 h, 10 h, 12 h and 13 h
Population: FAS consisted of all participants randomized to treatment who had at least 1 post-dose SKAMP-Combined treatment assessment during the classroom testing session on Visit 8. Participants were analyzed as randomized.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo | Onset of Effect | 1 hour |
The Average of the Permanent Product Measure of Performance - Attempted (PERMP-A) Score
The PERMP consisted of 400 math problems and was graded as number of problems Attempted (PERMP-A) and number of problems Correct. (PERMP-C). It was an objective measure of performance during the classroom testing day.
Time frame: Visit 8 (Day 42)
Population: FAS consisted of all participants randomized to treatment who had at least 1 post-dose SKAMP-Combined treatment assessment during the classroom testing session on Visit 8. Participants were analyzed as randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | The Average of the Permanent Product Measure of Performance - Attempted (PERMP-A) Score | 82.0 number of problems attempted | Standard Deviation 39.55 |
| NT0102 | The Average of the Permanent Product Measure of Performance - Attempted (PERMP-A) Score | 107.5 number of problems attempted | Standard Deviation 57.53 |
The Average of the Permanent Product Measure of Performance - Correct (PERMP-C) Score
The PERMP consisted of 400 math problems and was graded as number of problems Attempted (PERMP-A) and number of problems Correct. (PERMP-C). It was an objective measure of performance during the classroom testing day.
Time frame: Visit 8 (Day 42)
Population: FAS consisted of all participants randomized to treatment who had at least 1 post-dose SKAMP-Combined treatment assessment during the classroom testing session on Visit 8. Participants were analyzed as randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | The Average of the Permanent Product Measure of Performance - Correct (PERMP-C) Score | 78.6 number of problems correct | Standard Deviation 40.6 |
| NT0102 | The Average of the Permanent Product Measure of Performance - Correct (PERMP-C) Score | 104.1 number of problems correct | Standard Deviation 58.27 |
The Average of the SKAMP-Attention Scores
The SKAMP Rating Scale was comprised of 2 behavioral subscales, including the Attention subscale (4 items). The SKAMP-Attention subscore evaluates concentration in the classroom and is obtained by summing up each item score where each item is rated on a 7-point impairment scale (0=normal to 6=maximal impairment) for total possible combined score of 0 to 24. A lower score indicates less symptomatology (i.e. is better). The SKAMP-Attention subscores were derived from 20 minutes of direct observations of participant behavior. Ratings were based on the frequency and quality of behaviors.
Time frame: Visit 8 (Day 42)
Population: The per-protocol set were a subset of the FAS consisting of those participants who satisfied all of the inclusion/exclusion criteria and who correctly received the treatment to which they were randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | The Average of the SKAMP-Attention Scores | 12.2 score on a scale | Standard Deviation 4.2 |
| NT0102 | The Average of the SKAMP-Attention Scores | 9.4 score on a scale | Standard Deviation 3.42 |
The Average of the SKAMP-Deportment Scores
The SKAMP Rating Scale is comprised of 2 behavioural subscales, including the Deportment subscale (4 items). The SKAMP-Deportment subscore evaluates behaviour in the classroom and is obtained by summing up each item score where each item is rated on a 7-point impairment scale (0=normal to 6=maximal impairment) for total possible combined score of 0 to 24. A lower score indicates less symptomatology (i.e. is better). The SKAMP-Attention subscores were derived from 20 minutes of direct observations of participant behaviour. Ratings were based on the frequency and quality of behaviours.
Time frame: Visit 8 (Day 42)
Population: The Per-Protocol Set were a subset of the FAS consisting of those participants who satisfied all of the inclusion/exclusion criteria and who correctly received the treatment to which they were randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | The Average of the SKAMP-Deportment Scores | 12.5 score on a scale | Standard Deviation 6.23 |
| NT0102 | The Average of the SKAMP-Deportment Scores | 7.9 score on a scale | Standard Deviation 5.26 |