Skip to content

A Pilot Treatment Study of Insulin-Like Growth Factor-1 (IGF-1) in Autism Spectrum Disorder

A Pilot Treatment Study of Insulin-Like Growth Factor-1 (IGF-1) in Autism Spectrum Disorder

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01970345
Enrollment
3
Registered
2013-10-28
Start date
2014-05-31
Completion date
2017-09-13
Last updated
2024-02-08

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

Conditions

Autism Spectrum Disorder

Keywords

Autism Spectrum Disorder, IGF-1

Brief summary

The proposed project will pilot the use of IGF-1 as a novel treatment for core symptoms of autism. We will use a double-blind, placebo-controlled crossover trial design in five children with autism to evaluate the impact of IGF-1 treatment on autism-specific impairments in socialization, language, and repetitive behaviors. We expect to provide evidence for the safety and feasibility of IGF-1 in ameliorating social withdrawal in children with Autistic Disorder. Further, we expect to demonstrate that IGF-1 is associated with improvement on secondary outcomes of social impairment, language delay, and repetitive behavior, as well as on functional outcomes of global severity.

Detailed description

IGF-1 is an FDA approved, commercially available compound that crosses the blood-brain barrier and has beneficial effects on synaptic development by promoting neuronal cell survival, synaptic maturation, and synaptic plasticity. IGF-1 is effective in reversing mouse and neuronal models of Rett syndrome and Phelan McDermid syndrome, both single gene causes of ASD and may therefore be effective in treating autism spectrum disorders (ASD) more broadly.

Interventions

DRUGIGF-1

IGF-1 is an FDA-approved (IND exemption #113450), commercially available compound that crosses the blood-brain barrier and has beneficial effects on synaptic development by promoting neuronal cell survival, synaptic maturation, and synaptic plasticity.

Placebo

Sponsors

Autism Science Foundation
CollaboratorOTHER
Icahn School of Medicine at Mount Sinai
Lead SponsorOTHER

Study design

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

Eligibility

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

Inclusion criteria

* Meet DSM-5 criteria for Autism Spectrum Disorder confirmed by the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule- Generic (ADOS-G) * Children between the ages of 5-12 years of age * Language delay (lack of fluent phrase speech) reflected by use of ADOS Module 1 or 2 * Must be on stable medication regimens for at least three months prior to enrollment, assuming the concomitant medication is safe for use with IGF-1

Exclusion criteria

* Closed epiphyses * Active or suspected neoplasia * Intracranial hypertension * Hepatic insufficiency * Renal insufficiency * Cardiomegaly/valvulopathy * History of allergy to IGF-1 * Patients with comorbid conditions deemed too medically compromised to tolerate the risk of experimental treatment with IGF-1

Design outcomes

Primary

MeasureTime frameDescription
Aberrant Behavior Checklist - Social Withdrawal SubscalePhase 1 - Week 4 and 12, Phase 2 - Week 4 and 8Aberrant Behavior Checklist - Social Withdrawal Subscale has16 items, Each item is scored as 0 (never a problem), 1 (slight problem), 2 (moderately serious problem), or 3 (severe problem). Total Subscale scores range from 0 to 48. Higher score indicates poorer health outcomes.

Secondary

MeasureTime frameDescription
Repetitive BehaviorPhase 1 - Week 4 and 12, Phase 2 - Week 4 and 8Repetitive Behavior: Repetitive Behavior Scale (RBS) - Includes 43 items scored 0 (behavior does not occur), 1 (behavior occurs and is a mild problem), 2 (behavior occurs and is a moderate problem), 3 (behavior occurs and is a severe problem). Full scale from 0-129, with higher scores indicating worse outcomes.
Caregiver StrainPhase 1 - Week 4 and 12, Phase 2 - Week 4 and 8Caregiver Strain Index - 21 question tool, with response 1 (not al all) - 5 (very much). Total score on scale from 21-105. Higher score indicates poorer health outcomes.
Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Week 4 of Phase 1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI) - Each item is marked as 0 (does not show the behavior), 1 (rarely shows the behavior), 2 (sometimes/partially shows the behavior), 3 (usually/typically shows the behavior), or ? (uncertain/don't understand). The Sensory, Ritual, Social Pragmatic, Semantic Pragmatic, Arouse, Specific Fears, and Aggressiveness subscales range from 0 to 100, where higher score indicates worse severity than the average child with autism. The Social Approach, Expressive, and Learning Memory subscales range from 0 to 100, where higher score indicates better skills relative to the average child with autism. Scores reported in subscales. Scores were not reported as full scale.
The Clinical Global Impression - Severity Scale (CGI-S)Phase 1 - Week 4 and 12, Phase 2 - Week 4 and 8The 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. Full scale is 1 (normal, not at all ill) to 7 (extremely ill).
Vineland Adaptive Behavior Composite ScoreBaseline and Phase 1 Week 12The Vineland Adaptive Behavior Scales, Second Edition (Survey Interview Form) yields an overall standard score (Adaptive Behavior Composite, ABC) and age standard scores in four domains. ABC scores have a mean of 100 and a standard deviation of 15 (range = 20 to 160). Higher scores suggest a higher level of adaptive functioning.
Children's Yale-Brown Obsessive Compulsive Disorder Scale for Pervasive Developmental DisordersPhase 1 - Week 4 and 12, Phase 2 - Week 4 and 8Clinician-rated interview designed to evaluate repetitive behavior in children with pervasive developmental disorders (PDDs). It is a modification of the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), developed to assess typically-developing children with obsessive compulsive behavior. Because of language limitations in children with PDDs the CY-BOCS-PDD only includes the five compulsion items: Time Spent, Interference, Distress, Resistance of repetitive behavior, and Control of repetitive behavior. Each item is rated from 0 (none) through 4 (extreme), and scores can range from 0 to 20, with higher scores reflecting more severe symptoms. Usually a score 8 is considered clinically significant.

Countries

United States

Participant flow

Recruitment details

Decision made to terminate due to difficulty in procurement of adequate supply of treatment drug. Decision made on April 2023 to terminate study. However last participant visit was Sept 2017.

Participants by arm

ArmCount
Children With Autism Spectrum Disorders
Randomized, placebo-controlled, crossover format with 12 weeks in each treatment arm (IGF-1 and placebo), separated by a four-week wash-out phase.
3
Total3

Withdrawals & dropouts

PeriodReasonFG000FG001
First Treatment Phase 12 WeeksWithdrawal by Subject11
Second Treatment Phase 12 WeeksWithdrawal by Subject01

Baseline characteristics

CharacteristicChildren With Autism Spectrum Disorders
Age, Categorical
<=18 years
3 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
3 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
1 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
2 Participants
Sex: Female, Male
Female
0 Participants
Sex: Female, Male
Male
3 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 20 / 2
other
Total, other adverse events
2 / 22 / 2
serious
Total, serious adverse events
0 / 20 / 2

Outcome results

Primary

Aberrant Behavior Checklist - Social Withdrawal Subscale

Aberrant Behavior Checklist - Social Withdrawal Subscale has16 items, Each item is scored as 0 (never a problem), 1 (slight problem), 2 (moderately serious problem), or 3 (severe problem). Total Subscale scores range from 0 to 48. Higher score indicates poorer health outcomes.

Time frame: Phase 1 - Week 4 and 12, Phase 2 - Week 4 and 8

Population: Results for participants who were still on study.

ArmMeasureGroupValue (MEAN)Dispersion
IGF-1Aberrant Behavior Checklist - Social Withdrawal SubscaleWeek 4, phase 120 score on a scale
IGF-1Aberrant Behavior Checklist - Social Withdrawal SubscaleWeek 4, phase 23 score on a scale
IGF-1Aberrant Behavior Checklist - Social Withdrawal SubscaleWeek 8, Phase 22 score on a scale
PlaceboAberrant Behavior Checklist - Social Withdrawal SubscaleWeek 4, phase 120 score on a scaleStandard Deviation 18.4
PlaceboAberrant Behavior Checklist - Social Withdrawal SubscaleWeek 12, Phase 14 score on a scale
Secondary

Caregiver Strain

Caregiver Strain Index - 21 question tool, with response 1 (not al all) - 5 (very much). Total score on scale from 21-105. Higher score indicates poorer health outcomes.

Time frame: Phase 1 - Week 4 and 12, Phase 2 - Week 4 and 8

Population: Data provided for participants who were on study

ArmMeasureGroupValue (MEAN)Dispersion
IGF-1Caregiver StrainWeek 8, Phase 254 score on a scale
IGF-1Caregiver StrainWeek 4, Phase 171 score on a scale
IGF-1Caregiver StrainWeek 4, Phase 254 score on a scale
PlaceboCaregiver StrainWeek 4, Phase 187 score on a scaleStandard Deviation 9.9
PlaceboCaregiver StrainWeek 12, Phase 173 score on a scale
Secondary

Children's Yale-Brown Obsessive Compulsive Disorder Scale for Pervasive Developmental Disorders

Clinician-rated interview designed to evaluate repetitive behavior in children with pervasive developmental disorders (PDDs). It is a modification of the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), developed to assess typically-developing children with obsessive compulsive behavior. Because of language limitations in children with PDDs the CY-BOCS-PDD only includes the five compulsion items: Time Spent, Interference, Distress, Resistance of repetitive behavior, and Control of repetitive behavior. Each item is rated from 0 (none) through 4 (extreme), and scores can range from 0 to 20, with higher scores reflecting more severe symptoms. Usually a score 8 is considered clinically significant.

Time frame: Phase 1 - Week 4 and 12, Phase 2 - Week 4 and 8

Population: data not collected

Secondary

Repetitive Behavior

Repetitive Behavior: Repetitive Behavior Scale (RBS) - Includes 43 items scored 0 (behavior does not occur), 1 (behavior occurs and is a mild problem), 2 (behavior occurs and is a moderate problem), 3 (behavior occurs and is a severe problem). Full scale from 0-129, with higher scores indicating worse outcomes.

Time frame: Phase 1 - Week 4 and 12, Phase 2 - Week 4 and 8

Population: Data provided for participants who were on study

ArmMeasureGroupValue (MEAN)Dispersion
IGF-1Repetitive BehaviorWeek 4 of Phase 131 score on a scale
IGF-1Repetitive BehaviorWeek 4 of Phase 211 score on a scale
IGF-1Repetitive BehaviorWeek 8 of Phase 28 score on a scale
PlaceboRepetitive BehaviorWeek 4 of Phase 144 score on a scaleStandard Deviation 41
PlaceboRepetitive BehaviorWeek 12 of Phase 111 score on a scale
Secondary

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI) - Each item is marked as 0 (does not show the behavior), 1 (rarely shows the behavior), 2 (sometimes/partially shows the behavior), 3 (usually/typically shows the behavior), or ? (uncertain/don't understand). The Sensory, Ritual, Social Pragmatic, Semantic Pragmatic, Arouse, Specific Fears, and Aggressiveness subscales range from 0 to 100, where higher score indicates worse severity than the average child with autism. The Social Approach, Expressive, and Learning Memory subscales range from 0 to 100, where higher score indicates better skills relative to the average child with autism. Scores reported in subscales. Scores were not reported as full scale.

Time frame: Week 8 of Phase 2

Population: Data provided for participants who completed week 8. Data not provided by participant for one subscale.

ArmMeasureGroupValue (MEAN)
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Sensory5 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Ritual1 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Semantic Pragmatic9 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Arouse10 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Specific Fears7 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Aggressiveness6 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Approach60 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Expressive43 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Learning Memory14 score on a scale
Secondary

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI) - Each item is marked as 0 (does not show the behavior), 1 (rarely shows the behavior), 2 (sometimes/partially shows the behavior), 3 (usually/typically shows the behavior), or ? (uncertain/don't understand). The Sensory, Ritual, Social Pragmatic, Semantic Pragmatic, Arouse, Specific Fears, and Aggressiveness subscales range from 0 to 100, where higher score indicates worse severity than the average child with autism. The Social Approach, Expressive, and Learning Memory subscales range from 0 to 100, where higher score indicates better skills relative to the average child with autism. Scores reported in subscales. Scores were not reported as full scale.

Time frame: Week 4 of Phase 2

Population: Data provided for participants who completed week 4

ArmMeasureGroupValue (MEAN)
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Sensory11 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Ritual2 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Pragmatic13 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Semantic Pragmatic5 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Arouse16 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Specific Fears10 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Aggressiveness10 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Approach52 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Expressive36 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Learning Memory14 score on a scale
Secondary

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI) - Each item is marked as 0 (does not show the behavior), 1 (rarely shows the behavior), 2 (sometimes/partially shows the behavior), 3 (usually/typically shows the behavior), or ? (uncertain/don't understand). The Sensory, Ritual, Social Pragmatic, Semantic Pragmatic, Arouse, Specific Fears, and Aggressiveness subscales range from 0 to 100, where higher score indicates worse severity than the average child with autism. The Social Approach, Expressive, and Learning Memory subscales range from 0 to 100, where higher score indicates better skills relative to the average child with autism. Scores reported in subscales. Scores were not reported as full scale.

Time frame: Week 12 of Phase 1

Population: Data provided for participants who completed week 12

ArmMeasureGroupValue (MEAN)
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Sensory9 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Ritual4 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Pragmatic16 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Semantic Pragmatic8 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Arouse12 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Specific Fears22 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Aggressiveness18 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Approach59 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Expressive27 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Learning Memory15 score on a scale
Secondary

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)

Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI) - Each item is marked as 0 (does not show the behavior), 1 (rarely shows the behavior), 2 (sometimes/partially shows the behavior), 3 (usually/typically shows the behavior), or ? (uncertain/don't understand). The Sensory, Ritual, Social Pragmatic, Semantic Pragmatic, Arouse, Specific Fears, and Aggressiveness subscales range from 0 to 100, where higher score indicates worse severity than the average child with autism. The Social Approach, Expressive, and Learning Memory subscales range from 0 to 100, where higher score indicates better skills relative to the average child with autism. Scores reported in subscales. Scores were not reported as full scale.

Time frame: Week 4 of Phase 1

Population: Data provided for participants who completed week 4

ArmMeasureGroupValue (MEAN)Dispersion
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Sensory21 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Ritual9 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Pragmatic20 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Semantic Pragmatic19 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Arouse23 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Specific Fears13 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Aggressiveness7 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Approach75 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Expressive36 score on a scale
IGF-1Social Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Learning Memory0 score on a scale
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Approach31 score on a scaleStandard Deviation 15.6
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Sensory16 score on a scaleStandard Deviation 14.1
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Specific Fears25 score on a scaleStandard Deviation 1.4
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Ritual13 score on a scaleStandard Deviation 14.1
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Learning Memory8.5 score on a scaleStandard Deviation 2.1
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Social Pragmatic14 score on a scaleStandard Deviation 0
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Aggressiveness30 score on a scaleStandard Deviation 25.5
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Semantic Pragmatic0.5 score on a scaleStandard Deviation 0.7
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Expressive18.5 score on a scaleStandard Deviation 20.5
PlaceboSocial Pervasive Developmental Disorder-Behavior Inventory (PDDBI)Arouse20.5 score on a scaleStandard Deviation 6.4
Secondary

The Clinical Global Impression - Severity Scale (CGI-S)

The 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. Full scale is 1 (normal, not at all ill) to 7 (extremely ill).

Time frame: Phase 1 - Week 4 and 12, Phase 2 - Week 4 and 8

Population: Data provided for participants who were on study

ArmMeasureGroupValue (MEAN)Dispersion
IGF-1The Clinical Global Impression - Severity Scale (CGI-S)Week 4, Phase 15 score on a scale
IGF-1The Clinical Global Impression - Severity Scale (CGI-S)Week 8, Phase 24 score on a scale
PlaceboThe Clinical Global Impression - Severity Scale (CGI-S)Week 4, Phase 15 score on a scaleStandard Deviation 1.4
PlaceboThe Clinical Global Impression - Severity Scale (CGI-S)Week 12, Phase 14 score on a scale
PlaceboThe Clinical Global Impression - Severity Scale (CGI-S)Week 4, Phase 24 score on a scale
Secondary

Vineland Adaptive Behavior Composite Score

The Vineland Adaptive Behavior Scales, Second Edition (Survey Interview Form) yields an overall standard score (Adaptive Behavior Composite, ABC) and age standard scores in four domains. ABC scores have a mean of 100 and a standard deviation of 15 (range = 20 to 160). Higher scores suggest a higher level of adaptive functioning.

Time frame: Baseline and Phase 1 Week 12

Population: Data collected at baseline and Week 12 and only for participants on study.

ArmMeasureGroupValue (MEAN)Dispersion
IGF-1Vineland Adaptive Behavior Composite ScoreBaseline55 T-score
PlaceboVineland Adaptive Behavior Composite ScoreBaseline51 T-scoreStandard Deviation 8.5
PlaceboVineland Adaptive Behavior Composite ScoreWeek 12, Phase 157 T-score

Source: ClinicalTrials.gov · Data processed: Feb 5, 2026