E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Autism or Asperger’s Disorder or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Psychiatry and Psychology [F] - Behavioral Disciplines and Activities [F04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10008520 |
E.1.2 | Term | Childhood autism |
E.1.2 | System Organ Class | 100000004852 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10003484 |
E.1.2 | Term | Asperger's disorder |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10034739 |
E.1.2 | Term | Pervasive developmental disorder NOS |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The objective of this study is to evaluate the safety and tolerability of memantine in pediatric (6-12 years old) patients with autism, Asperger’s Disorder, or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and to identify responders for participation in the follow-up randomized withdrawal study |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
To be eligible to participate in the study, patients must meet the following criteria:
1. Provide written informed assent, when developmentally appropriate, to participate in the study before conduct of any study-specific procedures. The parent/guardian/LAR must provide written informed consent before the patient’s participation in the study. A separate written informed consent for the caregiver must also be obtained before the conduct of any study specific procedures.
2. Male or female outpatients
3. Age of 6-12
4. Females who are 9 years and older or who have had onset of menses must have a negative serum pregnancy test at screening
5. Meet DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) diagnostic criteria for autism, Asperger’s Disorder, or PDD-NOS based on both:
○ ADOS (Autism Diagnostic Observation Schedule) Modules 2 or 3
○ ADI-R (Autism Diagnostic Interview–Revised)
ADOS completed within the 6 months before Screening and ADI-R completed within the 3 months before Screening are acceptable provided that the assessments were done by a qualified rater. A copy of the scores must be available for the source file and the eCRF.
6. Normal physical examination and laboratory test results at Screening (Visit 0) or any abnormal findings must be deemed not clinically significant by the Investigator and documented
7. Normal sitting pulse rate by vital sign assessment. Any deviation from normal must be judged not clinically significant by the Investigator. Please refer to Appendix V for Normal ranges
8. Normal sitting blood pressure (BP). Any deviation from normal must be judged not clinically significant by the Investigator.
9. Ability to tolerate venipuncture procedures for blood sampling
10. A knowledgeable caregiver capable of providing reliable information about the patient’s condition, able to attend all clinic visits with the patient, and able to oversee the administration of investigational product. Every effort should be made to maintain the same caregiver throughout the study
11. Have a family that is sufficiently organized and stable to guarantee adequate safety monitoring and continuous attendance to clinic visits for the duration of the study
12. Be able to speak and understand English sufficiently (or their native language if this can be accommodated by the site), as well as have a caregiver and parent/guardian/LAR who is able to speak and understand English sufficiently (or their native language if this can be accommodated by the site), to comprehend the nature of the study and to allow for the completion of all study assessments
13. Verbally fluent (at least three-word phrases). Must use some phrase speech if not verbally fluent
14. An SRS (Social Responsiveness Scale) total raw score > 44 for females and > 53 for males
15. An IQ in the not mentally retarded or mildly retarded range as measured by a standardized score of 50 or higher on the Kaufman Brief Intelligence Test, Version 2, or by other standard IQ test used for non-English speakers and in the countries outside the United States and Canada where the study is being conducted, at Screening (Visit 0) |
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E.4 | Principal exclusion criteria |
Patients who meet any of the following criteria will not be eligible to participate in the
study:
1. Have enrolled in Study MEM-MD-57A
2. History of premature birth (before 35 weeks gestational age or weight of < 5 lb at birth)
3. History of hypersensitivity reaction to memantine, dextromethorphan, amantadine, or any other NMDA receptor antagonists
4. Having any primary psychiatric (Axis I) diagnosis other than autism, Asperger’s Disorder, and PDD-NOS
5. Meeting DSM-IV-TR criteria for bipolar I disorder, psychotic disorder not otherwise specified, posttraumatic stress disorder, schizophrenia, or major depressive disorder within the past 6 months
6. An ABC (Aberrant Behavior Checklist) Irritability subscale (ABC-I) score ≥ 17 at Screening (Visit 0)
7. Significant risk of suicidality based on the investigator judgment, ABC-I, or if appropriate, as indicated by a response of “yes” to questions 3, 4, or 5 in the suicidal
ideation section of the Children’s Columbia-Suicide Severity Rating Scale (C-SSRS) at Screening (Visit 0) or any suicidal behavior within the past 6 months.
8. Taking, or having taken NMDA antagonists (eg, amantadine, ketamine, dextromethorphan) or any other excluded concomitant medications (Appendix III) within five half-lives or 4 weeks of Screening (Visit 0), whichever is shorter.
9. Medical history of neurological disease including, but not limited to, movement disorder; Tourette syndrome; tuberous sclerosis; fragile X syndrome; velocardiofacial syndrome; chromosome 15q duplication syndrome; Angelman syndrome; active epilepsy/seizure disorder (defined as seizure activity within 5 years of screening (Visit 0) except simple febrile seizures; known abnormal computed tomography/magnetic resonance imaging of the brain; or a structural lesion of the brain
10. Medical conditions that might interfere with the conduct of the study, confound interpretation of the study results, or endanger the patient’s well-being. Such conditions include, but are not limited to, evidence or history of malignancy or any significant hematologic, endocrine, cardiovascular (including any rhythm
disorder), respiratory, renal, hepatic, or gastrointestinal disease. If there is a history of such disease but the condition has been stable for more than 1 year and is judged by the Investigator not to interfere with the patient’s participation in the study, the
patient may be included, with the documented approval of the Study Physician
11. Clinically significant ECG abnormalities. Any deviation from normal must be judged not clinically significant by the Investigator. Please refer to Appendix V for out of normal ranges ECG values and findings
12. Participation in any other clinical investigation using an experimental drug or requiring repeated blood draws within 30 days of the start of this study or participation in a blood donation program within the past 60 days
13. Treatment with memantine or participation in an investigational study of memantine within 90 days of Screening (Visit 0)
14. Female patients of child-bearing potential who are not using or not willing to use a conventional method of contraception approved by the PI. Abstinence is an acceptable method of contraception
15. Patients who, in the Investigator’s and/or Sponsor’s opinion, might not be suitable for te study
16. Employee or immediate relative of an employee of Forest Laboratories, Inc., any of its affiliates or partners, or the study center |
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E.5 End points |
E.5.1 | Primary end point(s) |
1) Complete at least 12 weeks of exposure to investigational product and
2) Meet the responder criterion at two consecutive visits separated by at least two weeks. A patient will be considered a responder if he or she presented at least 10 points improvement (reduction in score) in SRS relative to the Visit 1 total raw score. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Patients meeting the confirmed responder criteria any time at or after Visit 5 (end of Week 12) will be expected to transition to a follow-up randomized withdrawal study (MEM-MD-68). SRS will be administered at Visits 0, 1, 4A, 5, 5A, 6, 6A, 7, 7A, 8, and confirmatory visits. |
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E.5.2 | Secondary end point(s) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Not applicable as no secondary objectives |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 31 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Belgium |
Colombia |
Denmark |
Finland |
France |
Germany |
Hungary |
Iceland |
Ireland |
Italy |
Korea, Republic of |
Mexico |
Netherlands |
New Zealand |
Norway |
Philippines |
Poland |
Russian Federation |
Serbia |
Singapore |
South Africa |
Spain |
Sweden |
Taiwan |
Thailand |
Ukraine |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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This study will be terminated when the required number of patients transition into the follow-up randomized withdrawal study. Patients active at the time of study termination will return to the site for final evaluations (Visit 8/ET) at the earliest opportunity and will be considered study completers, and will be eligible to continue in a follow-up open-label study.
Forest, reserves the right to terminate the study in its entirety or at a specific study center before study completion. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 13 |