Attention Deficit/Hyperactivity Disorder (ADHD - Pediatric)
April 18, 2016
Shire released results of a phase III, randomized, double-blind, multicenter, placebo-controlled, dose-optimization, safety and efficacy study of SHP465 in children and adolescents aged 6 to 17 years with Attention-Deficit/Hyperactivity Disorder (ADHD). The primary efficacy analysis of study 305 demonstrated that SHP465, administered as a daily morning dose, was superior to placebo on the change from baseline in ADHD-RS-IV (ADHD rating scale) total score, with a Least Squares (LS) mean difference from placebo at Week 4 of -9.9 (95% CI: -13.0 to -6.8, p<0.001), suggesting a significant improvement in ADHD symptoms. SHP465 was also superior to placebo in the key secondary efficacy analysis on the clinical global impression improvement scale (CGI-I), with an LS mean difference from placebo at Week 4 of -0.8 (95% CI: -1.1 to -0.5, p<0.001), indicating a significantly higher proportion of patients were rated improved on the CGI-I rating scale. Treatment-emergent adverse events ≥ 5% for SHP 465-305 were decreased appetite, headache, insomnia, irritability, nausea, weight decrease and dizziness. Adverse events were generally mild to moderate in severity and similar to those observed in previous SHP465 studies and with other amphetamine compounds. Once a pharmacokinetic study and an additional safety and efficacy phase III trial in adults currently under way are complete later this year, Shire plans to add these study results to its existing SHP465 data set to submit a Class 2 resubmission for FDA approval for ADHD.
November 24, 2014
Ironshore Pharmaceuticals & Development
issued results of a phase III study of HLD-
200 in pediatric subjects with attention-deficit
hyperactivity disorder (ADHD). The trial enrolled
43 pediatric patients aged six to 12. Following
a six-week, open-label, treatment-optimization
phase, subjects then entered into a doubleblind,
placebo-controlled, one-week randomized,
parallel-group test period designed to
assess the safety and efficacy of HLD-200 treatment.
Patients on HLD-200 treatment showed
a statistically significant improvement in ADHD
symptoms (p<0.0027) compared to placebo
over this period. Patients treated with HLD-200
showed a statistically significant improvement
at 6:00pm (p=0.0022) and a trend toward
significance at 8:00pm (p=0.168). Patients in the
HLD-200 group showed a 58.5% improvement
relative to their baseline Before School Functioning
Questionnaire (BSFQ) scores. There were no
serious adverse events throughout the study.
The company plans to conduct a pivotal trial in
the first half of 2015.
February 1, 2010
Supernus reported positive results from a phase IIa trial of SPN810 for the treatment of ADHD and persistent serious conduct problems. This proof-of-concept, open-label study enrolled pediatrics 6 to 12 years of age. The subjects were randomized according to weight and titrated to receive one of four doses over a six-week treatment period. All doses of SPN810 showed a statistically significant reduction versus baseline in conduct problems, with aggression as a key feature. SPN180 showed reductions of 32% at the lowest tested dose and 55% at the highest tested dose. Treatment was safe and well tolerated.
November 27, 2006
Shire reported positive results from a phase III trial of guanfacine XR for the treatment of ADHD symptoms in pediatrics aged 6 to 17. The double-blind trial enrolled 345 subjects who underwent a one week washout period, then were randomized to receive placebo or 2, 3 or 4 mg of guanfacine extended release, once daily, for eight weeks. Guanfacine XR was titrated in 1 mg increments per week, from 1 mg per day during the first week to a maximum of 4 mg daily in weeks four and five according to randomization. Guanfacine XR was then decreased at the same weekly rate starting in weeks six and seven. Treatment was well tolerated with no serious adverse events reported. The most commonly reported events included somnolence, headache and fatigue. Efficacy was based on ADHD Rating Scale (ADHD-RS-IV) measurements. The guanfacine XR treated group had an average reduction in ADHD-RS-IV total scores of 16.7 points versus 8.9 points for placebo (P < .0001). Significance was observed in all secondary endpoints as well, which included scores on various other ADHD diagnostic scales. A NDA is currently under review for guanfacine extended release.
March 7, 2005
New River Pharmaceuticals has announced results of a phase II trial of NRP104, for the treatment of pediatric Attention Deficit Hyperactivity Disorder (ADHD). Results from the study met their primary efficacy endpoint, with a significant improvement in symptom severity score on the SKAMP (Swanson, Kotkin, Agler, M.Flynn and Pelham) rating scale at all 3 trial doses, vs. placebo (p<0.0001). These results were non-inferior to those observed in subjects receiving approved therapy with Adderall XR, vs. placebo. This double-blind, placebo- and active- controlled, randomized, 3-treatment, 3-period crossover study enrolled 52 children (ages 6-12) with ADHD, who received one of 3 regimens of NRP104, Adderall XR, or placebo.
October 28, 2002
Celltech reported positive preliminary results from a comparative phase IV clinical trial of Metadate (methylphenidate HCl, USP) and McNeil's Concerta (methylphenidate HCl). Both drugs are indicated for the treatment of attention deficit hyperactivity disorder (ADHD). The randomized, double blind, placebo-controlled study consisted of 184 pediatric subjects at 10 sites throughout the U.S. Both drugs were shown to achieve better symptom control than placebo throughout the 7.5-hour observation period. Treatment with Metadate resulted in a 41% greater improvement in symptom scores relative to Concerta during this period. Subjects were evaluated during an actual laboratory classroom day on days 7, 14 and 21. Classroom activities were completed, and a SKAMP deportment evaluation was performed as the primary outcome measure at 1.5-hour intervals until the 7.5-hour time point following dosage administration.
September 23, 2002
Cephalon announced positive results from a four-week randomized, double-blind, placebo-controlled parallel design study of Provigil Tablets for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). 248 subjects between the ages of six and thirteen were assigned to one of four dose regimens of Provigil daily or placebo. The primary efficacy endpoint was the teacher completed school version of the ADHD Rating Scale IV. All of the groups treated with Provigil showed a reduction in symptoms of ADHD with 300 mg of Provigil once a day demonstrating the most significant reduction compared to placebo.
June 10, 2002
Study results show that a once-daily morning dose of Elan and Novartis' Ritalin LA (methylphenidate HCl) extended-release capsules reduces attention deficit/hyperactivity disorder (ADHD) symptoms in both home and school settings. The double-blind, randomized, placebo-controlled trial included 160 ADHD subjects between the ages of six and 12. The presence of ADHD symptoms in school and home environments was evaluated to determine efficacy. In this analysis, the primary outcome was measured by the change from baseline in the Conners ADHD/DSM-IV total subscale for teachers (CADS-T). Results showed that Ritalin LA was statistically superior to placebo in managing ADHD symptoms in all primary and secondary efficacy variables.