SPD503 (Guanfacine Hydrochloride) in ADHD Plus Oppositional Symptoms

Sponsor
Shire (Industry)
Overall Status
Completed
CT.gov ID
NCT00367835
Collaborator
(none)
217
34
2
13
6.4
0.5

Study Details

Study Description

Brief Summary

To assess efficacy and safety of SPD503(guanfacine hydrochloride) in subjects with ADHD and oppositional symptoms.

Condition or Disease Intervention/Treatment Phase
  • Drug: SPD503 (Guanfacine hydrochloride)
  • Drug: Placebo
Phase 3

Study Design

Study Type:
Interventional
Actual Enrollment :
217 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
A Double-Blind, Randomized, Multi-Center, Flexible Dose Study Evaluating the Efficacy and Safety of SPD503 (Guanfacine Hydrochloride) in Children Aged 6-12 With Symptoms of Oppositionality and a Diagnosis of Attention Deficit/Hyperactivity Disorder
Actual Study Start Date :
Dec 4, 2006
Actual Primary Completion Date :
Jan 4, 2008
Actual Study Completion Date :
Jan 4, 2008

Arms and Interventions

Arm Intervention/Treatment
Experimental: SPD503 (Guanfacine hydrochloride)

Drug: SPD503 (Guanfacine hydrochloride)
Subjects will start at 1mg tablet each morning and will subsequently be titrated (in 1 mg weekly increments) to optimal dose based upon tolerance and response to investigational product (not to exceed 4 mg/day).

Placebo Comparator: Placebo

Drug: Placebo
Placebo

Outcome Measures

Primary Outcome Measures

  1. Change From Baseline in the Oppositional Subscale of the Conners' Parent Rating Scale-Revised Long Form (CPRS-R:L) Score at Up to 8 Weeks [Baseline and up to 8 weeks]

    The oppositional subscale of the CPRS-R:L contains 10 items designed to reflect criteria for oppositional defiance disorder (ODD). Each item is scored on a range from 0 (not true at all) to 3 (very much true) with total scores ranging from 0 to 30. Higher scores are reflective of more severe symptoms.

Secondary Outcome Measures

  1. Change From Baseline in Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS-IV) Total Score at Up to 8 Weeks [Baseline and up to 8 weeks]

    The ADHD-RS-IV consists of 18 items scored on a 4-point scale ranging from 0 (no symptoms) to 3 (severe symptoms) with total score ranging from 0 to 54.

  2. Assessment of Clinical Global Impression-Severity of Illness (CGI-S) [up to 8 weeks]

    CGI-S assesses the severity of the subject's condition on a 7-point scale ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill)

  3. Number of Participants With Improvement on Clinical Global Impression-Improvement (CGI-I) [up to 8 weeks]

    CGI-I consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement is defined as a score of 1 (very much improved) or 2 (much improved) on the scale.

  4. Change From Baseline in the 40-Item Conduct Problem Scale of the New York Parent's Rating Scale-School-aged (NYPRS-S) Score at Up to 8 Weeks [Baseline and up to 8 weeks]

    Each item on the NYPRS-S is scored from a range of 0 (not at all) to 3 (very much) with total scores ranging from 0 to 120. Higher scores are reflective of increased disease severity.

  5. Change From Baseline in the Parent Stress Index-Short Form (PSI/SF) Score at Up to 8 Weeks [Baseline and up to 8 weeks]

    The response to each of the 36 items on the PSI/SF is converted to a five-point scale from 1 (strongly agree) to 5 (strongly disagree) with total scores ranging from 36 to 180. A higher score is reflective of less stress for the parents.

  6. Number of Participants With Overall Satisfaction on the Medication Satisfaction Survey (MSS) [up to 8 weeks]

    The Medication Satisfaction Survey (MSS) consists of 11 questions each being answered with one of six responses (strongly agree, agree, somewhat agree, somewhat disagree, disagree, strongly disagree). Overall satisfaction with their child taking the study medication, Question #11, with a response of "strongly agree" or "agree".

  7. Change From Baseline in Electrocardiogram Results (QTcF Interval) at Up to 8 Weeks [Baseline and up to 8 weeks]

    QTcF is the QT interval using Fridericia's correction formula. QT interval is a measure of time between the start of the Q wave and the end of the T wave and is dependent on the heart rate (e.g., the faster the heart rate, the shorter the QT interval). The QT interval has to be corrected in order to aid interpretation.

  8. Change From Baseline in Pulse Rate at Up to 8 Weeks [Baseline and up to 8 weeks]

  9. Change From Baseline in Systolic Blood Pressure at Up to 8 Weeks [Baseline and up to 8 weeks]

  10. Change From Baseline in Diastolic Blood Pressure at Up to 8 Weeks [Baseline and up to 8 weeks]

Eligibility Criteria

Criteria

Ages Eligible for Study:
6 Years to 12 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Healthy subjects with ADHD and oppositional symptoms

  • ADHD-RS>=24

  • CGI >=4

  • T-score of Opp subscale CPRS-R:L >=65

  • Normal ECG and BP

  • = 55 lbs

Contacts and Locations

Locations

Site City State Country Postal Code
1 HOPE Research Institute Phoenix Arizona United States 85050
2 Valley Clinical Research El Centro California United States 92243
3 Peninsula Research Associates Inc Rolling Hills Estates California United States 90274
4 Sarkis Clinical Trials Gainesville Florida United States 32607
5 University of Florida Gainesville Florida United States 32610
6 Amedica Research Institute, Inc Hialeah Florida United States 33013
7 CORE Research, Inc Maitland Florida United States 32751
8 Miami Research Associates Miami Florida United States 33143
9 Clinical Neuroscience Solutions, Inc Orlando Florida United States 32806
10 Childrens Developmental Center Winter Park Florida United States 32792
11 Capstone Clinical Research Libertyville Illinois United States 60048
12 Vince and Associates Clinical Research Overland Park Kansas United States 66212
13 Pedia Research Owensboro Kentucky United States 42301
14 Four Rivers Clinical Research Paducah Kentucky United States 42003
15 University of Nebraska Medical Center Omaha Nebraska United States 68198
16 CRI Worldwide, LLC Clementon New Jersey United States 08021
17 Mount Sinai School of Medicine New York New York United States 10029
18 University of Rochester, School of Medicine and Dentistry Rochester New York United States 14618
19 SUNY Upsate Medical University Syracuse New York United States 13210
20 Piedmont Neuropsychiatry Charlotte North Carolina United States 28226
21 Duke Child & Family Study Center Durham North Carolina United States 27705
22 University of Cincinnati Cincinnati Ohio United States 45267
23 Discovery and Wellness Center for Children Cleveland Ohio United States 44106
24 BHI Inc Moore Oklahoma United States 73160
25 IPS Research Company Oklahoma City Oklahoma United States 73103
26 Oregon Center for Clinical Investigations, Inc Portland Oregon United States 97210
27 Oregon Center for Clinical Investigations, Inc Salem Oregon United States 97301
28 CRI Worldwide, LLC Philadelphia Pennsylvania United States 19149
29 University of Pittsburgh Medical Center Pittsburgh Pennsylvania United States 15213
30 Claghorn-Lesem Research Clinic Inc Houston Texas United States 77008
31 Red Oak Psychiatry Associates, PA Houston Texas United States 77090
32 NeuroScience, Inc Herndon Virginia United States 20170
33 Dominion Clinical Research Midlothian Virginia United States 23112
34 Eastside Therapeutic Resource Kirkland Washington United States 98033

Sponsors and Collaborators

  • Shire

Investigators

  • Study Director: Study Director, Takeda

Study Documents (Full-Text)

None provided.

More Information

Additional Information:

Publications

None provided.
Responsible Party:
Shire
ClinicalTrials.gov Identifier:
NCT00367835
Other Study ID Numbers:
  • SPD503-307
First Posted:
Aug 23, 2006
Last Update Posted:
Jun 14, 2021
Last Verified:
Jun 1, 2021
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail 217 subjects were randomized (138 to SPD503 and 79 to placebo). However, only 214 subjects received at least one dose of study medication (136 for SPD503 and 78 for placebo). Therefore, 214 subjects constitute the safety population.
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Period Title: Overall Study
STARTED 138 79
COMPLETED 109 48
NOT COMPLETED 29 31

Baseline Characteristics

Arm/Group Title SPD503 Placebo Total
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride) Total of all reporting groups
Overall Participants 138 79 217
Age (Count of Participants)
<=18 years
138
100%
79
100%
217
100%
Between 18 and 65 years
0
0%
0
0%
0
0%
>=65 years
0
0%
0
0%
0
0%
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
9.4
(1.73)
9.3
(2.04)
9.4
(1.84)
Sex: Female, Male (Count of Participants)
Female
50
36.2%
19
24.1%
69
31.8%
Male
88
63.8%
60
75.9%
148
68.2%
Region of Enrollment (Count of Participants)
United States
138
100%
79
100%
217
100%

Outcome Measures

1. Primary Outcome
Title Change From Baseline in the Oppositional Subscale of the Conners' Parent Rating Scale-Revised Long Form (CPRS-R:L) Score at Up to 8 Weeks
Description The oppositional subscale of the CPRS-R:L contains 10 items designed to reflect criteria for oppositional defiance disorder (ODD). Each item is scored on a range from 0 (not true at all) to 3 (very much true) with total scores ranging from 0 to 30. Higher scores are reflective of more severe symptoms.
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
Full Analysis Set (FAS) defined as all randomized subjects who received at least one dose of any investigational product during this study and with a baseline and at least one post-baseline efficacy measurement.
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
Mean (Standard Deviation) [Units on a scale]
-10.8
(7.23)
-7.0
(7.63)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection SPD503, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method ANCOVA
Comments
2. Secondary Outcome
Title Change From Baseline in Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS-IV) Total Score at Up to 8 Weeks
Description The ADHD-RS-IV consists of 18 items scored on a 4-point scale ranging from 0 (no symptoms) to 3 (severe symptoms) with total score ranging from 0 to 54.
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
Mean (Standard Deviation) [Units on a scale]
-23.8
(14.43)
-11.4
(12.65)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection SPD503, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method ANCOVA
Comments
3. Secondary Outcome
Title Assessment of Clinical Global Impression-Severity of Illness (CGI-S)
Description CGI-S assesses the severity of the subject's condition on a 7-point scale ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill)
Time Frame up to 8 weeks

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
1 (Normal, not at all ill)
25
18.1%
3
3.8%
2 (Borderline mentally ill)
33
23.9%
6
7.6%
3 (Mildly ill)
29
21%
15
19%
4 (Moderately ill)
26
18.8%
24
30.4%
5 (Markedly ill)
13
9.4%
22
27.8%
6 (Severely ill)
4
2.9%
5
6.3%
7 (Among the most extremely ill)
0
0%
0
0%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection SPD503, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Cochran-Mantel-Haenszel
Comments
4. Secondary Outcome
Title Number of Participants With Improvement on Clinical Global Impression-Improvement (CGI-I)
Description CGI-I consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement is defined as a score of 1 (very much improved) or 2 (much improved) on the scale.
Time Frame up to 8 weeks

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
Number [Participants]
93
67.4%
24
30.4%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection SPD503, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Cochran-Mantel-Haenszel
Comments
5. Secondary Outcome
Title Change From Baseline in the 40-Item Conduct Problem Scale of the New York Parent's Rating Scale-School-aged (NYPRS-S) Score at Up to 8 Weeks
Description Each item on the NYPRS-S is scored from a range of 0 (not at all) to 3 (very much) with total scores ranging from 0 to 120. Higher scores are reflective of increased disease severity.
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
Mean (Standard Deviation) [units on a scale]
-15.6
(12.86)
-10.3
(13.25)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection SPD503, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method ANCOVA
Comments
6. Secondary Outcome
Title Change From Baseline in the Parent Stress Index-Short Form (PSI/SF) Score at Up to 8 Weeks
Description The response to each of the 36 items on the PSI/SF is converted to a five-point scale from 1 (strongly agree) to 5 (strongly disagree) with total scores ranging from 36 to 180. A higher score is reflective of less stress for the parents.
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 109 57
Mean (Standard Deviation) [Units on a scale]
17.3
(19.76)
7.2
(18.29)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection SPD503, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value 0.002
Comments
Method ANCOVA
Comments
7. Secondary Outcome
Title Number of Participants With Overall Satisfaction on the Medication Satisfaction Survey (MSS)
Description The Medication Satisfaction Survey (MSS) consists of 11 questions each being answered with one of six responses (strongly agree, agree, somewhat agree, somewhat disagree, disagree, strongly disagree). Overall satisfaction with their child taking the study medication, Question #11, with a response of "strongly agree" or "agree".
Time Frame up to 8 weeks

Outcome Measure Data

Analysis Population Description
FAS
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 129 69
Number [Participants]
84
60.9%
21
26.6%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection SPD503, Placebo
Comments
Type of Statistical Test Superiority or Other (legacy)
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method ANOVA
Comments
8. Secondary Outcome
Title Change From Baseline in Electrocardiogram Results (QTcF Interval) at Up to 8 Weeks
Description QTcF is the QT interval using Fridericia's correction formula. QT interval is a measure of time between the start of the Q wave and the end of the T wave and is dependent on the heart rate (e.g., the faster the heart rate, the shorter the QT interval). The QT interval has to be corrected in order to aid interpretation.
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
Safety population defined as all randomized subjects who received at least one dose of any investigational product during this study.
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 107 58
Mean (Standard Deviation) [msec]
5.2
(15.74)
2.1
(17.41)
9. Secondary Outcome
Title Change From Baseline in Pulse Rate at Up to 8 Weeks
Description
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
Safety population
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
Mean (Standard Deviation) [beats/min]
-4.3
(11.89)
0.7
(11.44)
10. Secondary Outcome
Title Change From Baseline in Systolic Blood Pressure at Up to 8 Weeks
Description
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
Safety population
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
Mean (Standard Deviation) [mmHg]
-2.6
(10.27)
0.7
(8.18)
11. Secondary Outcome
Title Change From Baseline in Diastolic Blood Pressure at Up to 8 Weeks
Description
Time Frame Baseline and up to 8 weeks

Outcome Measure Data

Analysis Population Description
Safety population
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
Measure Participants 130 75
Mean (Standard Deviation) [mmHg]
-1.3
(8.48)
0.9
(7.38)

Adverse Events

Time Frame
Adverse Event Reporting Description
Arm/Group Title SPD503 Placebo
Arm/Group Description Subjects will receive either 1, 2, 3, or 4 mg/day oral doses of SPD503 (Guanfacine hydrochloride)
All Cause Mortality
SPD503 Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN)
Serious Adverse Events
SPD503 Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/136 (0%) 0/78 (0%)
Other (Not Including Serious) Adverse Events
SPD503 Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 115/136 (84.6%) 47/78 (60.3%)
Gastrointestinal disorders
Abdominal pain upper 16/136 (11.8%) 2/78 (2.6%)
Vomiting 10/136 (7.4%) 5/78 (6.4%)
Nausea 4/136 (2.9%) 5/78 (6.4%)
General disorders
Fatigue 15/136 (11%) 4/78 (5.1%)
Infections and infestations
Upper respiratory tract infection 6/136 (4.4%) 4/78 (5.1%)
Investigations
Blood pressure diastolic decreased 8/136 (5.9%) 1/78 (1.3%)
Nervous system disorders
Somnolence 69/136 (50.7%) 5/78 (6.4%)
Headache 30/136 (22.1%) 14/78 (17.9%)
Sedation 18/136 (13.2%) 1/78 (1.3%)
Dizziness 7/136 (5.1%) 3/78 (3.8%)
Psychiatric disorders
Irritability 11/136 (8.1%) 2/78 (2.6%)
Affect lability 2/136 (1.5%) 4/78 (5.1%)
Respiratory, thoracic and mediastinal disorders
Pharyngolaryngeal pain 5/136 (3.7%) 4/78 (5.1%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

If a multicenter publication is not submitted within twelve (12) months after conclusion, abandonment or termination of the Study at all sites, or after Sponsor confirms there shall be no multicenter Study publication, the Institution and/or such Principal Investigator may publish the results from the Institution site individually

Results Point of Contact

Name/Title Study Director
Organization Shire
Phone +1 866 842 5335
Email ClinicalTransparency@shire.com
Responsible Party:
Shire
ClinicalTrials.gov Identifier:
NCT00367835
Other Study ID Numbers:
  • SPD503-307
First Posted:
Aug 23, 2006
Last Update Posted:
Jun 14, 2021
Last Verified:
Jun 1, 2021