Attention Deficit Hyperactivity Disorder
Conditions
Brief summary
The objective of this study was to evaluate the plasma amphetamine concentration/time profile of amphetamine extended release oral suspension in children aged 4 to 5 years with attention-deficit/hyperactivity disorder, following a single 2.5 mg dose of amphetamine extended release oral suspension.
Detailed description
DYANAVEL® XR is an extended-release oral suspension that contains 2.5 mg/mL amphetamine base (amphetamine extended-release oral suspension; AMPH EROS). Drug-resin complexation is formed with the amphetamine and sodium polystyrene sulfonate, an ion exchange resin. The extended release feature of the product is achieved by coating a portion of the drug/resin complexes with an extended release coating. AMPH EROS contains approximately a 3.2:1 ratio of d-amphetamine compared to l-amphetamine. The objective of this study was to evaluate the plasma amphetamine concentration/time profile of AMPH EROS in children aged 4 to 5 years with attention-deficit/hyperactivity disorder, following a single 2.5 mg dose of AMPH EROS. These data will guide appropriate dosing in planned safety and efficacy studies with AMPH EROS in a preschool population with attention-deficit/hyperactivity disorder.
Interventions
DRUGAmphetamine Extended Release Suspension [Dyanavel]
1 mL of study drug (AMPH EROS, 2.5 mg/mL), pharmacokinetic analysis
Sponsors
Tris Pharma, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This was an open-label, single-site, single-dose one-period, one-treatment study in 5 pediatric subjects diagnosed with ADHD, otherwise healthy. Subjects received a single, 1 mL dose of AMPH EROS 2.5 mg/mL, from which PK was assessed over a 28 hour period.
Eligibility
Sex/Gender
ALL
Age
4 Years to 5 Years
Healthy volunteers
Yes
Inclusion criteria
1. Male or female aged 4 to 5 years at the time of enrollment into this study; 2. Body weight ≥ 28 lb. at screening visit; 3. Diagnosed with ADHD by a psychiatrist, psychologist, developmental pediatrician, pediatrician, or an experienced licensed allied health professional approved by the Sponsor by using the DSM-5 criteria and supported by a structured Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL) interview, administered at the Screening Visit (Visit 0); 4. Provide written informed consent (parent/guardian) prior to participation in the study.
Exclusion criteria
1. Diagnosed with any DSM-5 active disorder (other than ADHD) with the exception of specific phobias, learning disorders, motor skills disorders, communication disorders,oppositional defiant disorder, elimination disorders, and sleep disorders 2. History of chronic medical illnesses including seizure disorder (excluding a history of febrile seizures), moderate to severe hypertension, untreated thyroid disease, known structural cardiac disorders, serious cardiac conditions, serious arrhythmias, cardiomyopathy and known family history of sudden death 3. Known history or presence of significant renal or hepatic disease, as indicated by clinical laboratory assessment (liver function test results ≥ 2 times the upper limit of normal, blood urea nitrogen, or creatinine) 4. Clinically significant (CS) abnormal ECG or cardiac findings on physical examination (including the presence of a pathologic murmur) 5. Use of the following medications within 30 days of dosing: * MAOI - monoamine oxidase inhibitors (e.g., Selegiline, isocarboxazid, phenelzine, tranylcypromine); * Tricyclic Antidepressants (e.g. Desipramine, protriptyline); 6. Use of the following medications within 3 days of dosing * Gastrointestinal acidifying agents (e.g., guanethidine, reserpine, glutamic acid HCl, ascorbic acid); * Urinary acidifying agents (e.g., ammonium chloride, sodium acid phosphate,methenamine salts); 7. Use of atomoxetine within 14 days of dosing 8. Planned use of prohibited drugs or agents from the screening visit through the end of the study. Medications used to support sleep may be acceptable with the written approval of the sponsor or medical monitor 9. Abnormal CS laboratory test value at screening that, in the opinion of the sponsor or medical monitor, would preclude study participation 10. Known history of allergy/hypersensitivity to amphetamine or any of the components of AMPH EROS, heparin flush and topical anesthetics 11. Parent or guardian's inability or unwillingness to follow directions of the Investigator or study research staff 12. Any uncontrolled medical condition that in the opinion of the Investigator would preclude study participation 13. History of significant illness requiring hospitalization, or surgery requiring anesthetics within 30 days of dosing.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Plasma Concentrations of d- and L-amphetamine | 0-28 hours postdose | Plasma Concentration of d- and l-amphetamine measured at 0, 1, 3, 4, 6, 8, 10, 12, and 28 hours postdose. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Study Patients (AMPH EROS) All patients treated with extended-release oral suspension (AMPH EROS) that contains 2.5 mg/mL amphetamine base
Amphetamine Extended Release Suspension \[Dyanavel\]: 1 mL of study drug (AMPH EROS, 2.5 mg/mL), pharmacokinetic analysis | 5 |
| Total | 5 |
Baseline characteristics
| Characteristic | Study Patients (AMPH EROS) |
|---|---|
| Age, Continuous | 4 Years STANDARD_DEVIATION 0 |
| Body Mass Index | 16.2 kg/m^2 STANDARD_DEVIATION 1.1 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 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 | 3 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 | 2 Participants |
| Sex: Female, Male Male | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 5 |
| other Total, other adverse events | 0 / 5 |
| serious Total, serious adverse events | 0 / 5 |
Outcome results
Primary
Plasma Concentrations of d- and L-amphetamine
Plasma Concentration of d- and l-amphetamine measured at 0, 1, 3, 4, 6, 8, 10, 12, and 28 hours postdose.
Time frame: 0-28 hours postdose
Population: intention to treat population
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 28 hours postdose | 2.2 ng/mL | Standard Deviation 0.7 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 0 hours postdose | 0 ng/mL | Standard Deviation 0 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 1 hour postdose | 3.5 ng/mL | Standard Deviation 3 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 3 hours postdose | 19.9 ng/mL | Standard Deviation 2.2 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 4 hours postdose | 20.2 ng/mL | Standard Deviation 2.5 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 6 hours postdose | 17.5 ng/mL | Standard Deviation 3.2 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 8 hours postdose | 16.9 ng/mL | Standard Deviation 2.2 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 10 hours postdose | 14.4 ng/mL | Standard Deviation 3.3 |
| Plasma Concentration of d-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 12 hours postdose | 11.6 ng/mL | Standard Deviation 3.2 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 10 hours postdose | 4.8 ng/mL | Standard Deviation 1.1 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 6 hours postdose | 5.7 ng/mL | Standard Deviation 1.1 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 0 hours postdose | 0 ng/mL | Standard Deviation 0 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 28 hours postdose | 0.9 ng/mL | Standard Deviation 0.2 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 1 hour postdose | 1.1 ng/mL | Standard Deviation 0.9 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 8 hours postdose | 5.6 ng/mL | Standard Deviation 0.8 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 3 hours postdose | 6.2 ng/mL | Standard Deviation 0.7 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 12 hours postdose | 3.9 ng/mL | Standard Deviation 1.1 |
| Plasma Concentration of l-Amphetamine | Plasma Concentrations of d- and L-amphetamine | 4 hours postdose | 6.4 ng/mL | Standard Deviation 0.8 |