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    Summary
    EudraCT Number:2015-001916-37
    Sponsor's Protocol Code Number:MATRICS_WP6-1
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:
    Date on which this record was first entered in the EudraCT database:2021-09-09
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2015-001916-37
    A.3Full title of the trial
    The neuropsychological characterization of aggressive behaviour in children and adolescents with Conduct Disorder or Oppositional Defiant Disorder (CD/ODD)
    Caratterizzazione neuropsicologica del comportamento aggressivo in bambini e adolescenti con Disturbo della Condotta o Disturbo Oppositivo Provocatorio
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    The neuropsychological features of aggressive behaviour in children and adolescents with diagnosis of Conduct Disorder or Oppositional Defiant Disorder (CD/ODD)
    Caratteristiche neuropsicologiche del comportamento aggressivo in bambini e adolescenti con diagnosi di Disturbo della Condotta o Disturbo Oppositivo Provocatorio
    A.3.2Name or abbreviated title of the trial where available
    The neuropsychological features of aggressive behaviour in children and adolescents with CD/ODD)
    Caratterizzazione neuropsicologica del comportamento aggressivo in bambini e adolescenti con CD/ODD
    A.4.1Sponsor's protocol code numberMATRICS_WP6-1
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorRADBOUD UNIVERSITY MEDICAL CENTER
    B.1.3.4CountryNetherlands
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing support7PQ Unione Europea
    B.4.2CountryEuropean Union
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationUniversità di Cagliari - Dipartimento di Scienze Biomediche, Clinica di Neuropsichiatria Infantile
    B.5.2Functional name of contact pointProject Management
    B.5.3 Address:
    B.5.3.1Street AddressPO Pediatrico Microcitemico (A.O. Brotzu), Via Jenner snc
    B.5.3.2Town/ cityCagliari
    B.5.3.3Post code09121
    B.5.3.4CountryItaly
    B.5.4Telephone number070 52963512
    B.5.5Fax number070 52963415
    B.5.6E-mailcaterina.medda@gmail.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Risperdal
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag SpA
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRISPERIDONE
    D.3.9.1CAS number 106266-06-2
    D.3.9.2Current sponsor codeJanssen-Cilag SpA
    D.3.9.3Other descriptive nameRISPERIDONE
    D.3.9.4EV Substance CodeSUB10335MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number0 to 1
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Abilify
    D.2.1.1.2Name of the Marketing Authorisation holderOtsuka Pharmaceutical Europe Ltd.
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNARIPIPRAZOLO
    D.3.9.1CAS number 129722-12-9
    D.3.9.2Current sponsor codeOtsuka Pharmaceutical Europe Ltd.
    D.3.9.3Other descriptive nameARIPIPRAZOLE
    D.3.9.4EV Substance CodeSUB05564MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number2 to 5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Strattera
    D.2.1.1.2Name of the Marketing Authorisation holderEli Lilly Italia S.p.A.
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNATOMOXETINA CLORIDRATO
    D.3.9.1CAS number 82248-59-7
    D.3.9.2Current sponsor codeEli Lilly Italia S.p.A.
    D.3.9.3Other descriptive nameATOMOXETINE
    D.3.9.4EV Substance CodeSUB20597
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number25 to 40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Medikinet
    D.2.1.1.2Name of the Marketing Authorisation holderMEDICE ArzneimittelPütter GmbH & Co. KG
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Modified-release capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNMETILFENIDATO CLORIDRATO
    D.3.9.1CAS number 113-45-1
    D.3.9.2Current sponsor codeMEDICE ArzneimittelPütter GmbH & Co. KG
    D.3.9.3Other descriptive nameMETHYLPHENIDATE
    D.3.9.4EV Substance CodeSUB03254MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number15 to 20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Aggressive behavior in children and adolescents with Conduct Disorder (CD) or Oppositional Defiant Disorder (ODD)
    Aggressività in bambini e adolescenti affetti da Disturbo della Condotta (CD) o Disturbo Oppositivo Provocatorio (ODD)
    E.1.1.1Medical condition in easily understood language
    Aggressive behavior in children and adolescents with a psychiatric diagnosis of Conduct Disorder or Oppositional Defiant Disorder
    Aggressività in bambini e adolescenti con diagnosi psichiatrica di Disturbo della Condotta o Disturbo Oppositivo Provocatorio
    E.1.1.2Therapeutic area Psychiatry and Psychology [F] - Psychological processes [F02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10037183
    E.1.2Term Psychic disturbance
    E.1.2System Organ Class 100000004873
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Our main goal is to first compare neuropsychological and autonomic functioning in children and adolescents with clinically relevant levels of aggression and diagnosis of ODD or CD to Typically Developing (TD) controls.
    We primarily aim to explore if conduct problems and aggression symptoms are related to specific neuropsychological (attention, working memory, decision making and risk taking, social cognition, delay aversion, emotional processing, motivation, cooperation, reward-punishment sensitivity), and autonomic (hearth rate, skin conductance, salivary cortisol) profiles, in order to differentiate subjects with aggression and CD/ODD from healthy controls. Moreover our aim is to examine if specific neuropsychological and autonomic profiles in patients with aggression symptoms permit to distinguish between reactive (“impulsive”, “affective” or “overt”) versus instrumental (“predatory”, “planned”) aggression in order to better subtyping different aggressive behaviours.
    Valutare il funzionamento cognitivo neuropsicologico e autonomico in bambini e adolescenti con aggressività e diagnosi di ODD o CD e compararli con soggetti di controllo con sviluppo tipico. Lo scopo principale sarà quindi stabilire se i problemi della condotta e i sintomi di aggressività siano correlati a specifici profili neuropsicologici misurati attraverso una batteria di test al computer (attenzione, memoria di lavoro, decision making, valutazione del rischio, cognizione sociale, avversione per l’attesa, processamento delle emozioni, motivazione, cooperazione, sensibilità alle ricompense/punizioni) e se siano correlabili a specifici profili autonomici (frequenza cardiaca e conduttanza cutanea) che differenzino i soggetti CD/ODD dai controlli sani. Inoltre valuteremo se specifici profili neuropsicologici e autonomici riscontrati in pazienti con aggressività, consentano di distinguere tra aggressività reattiva (“impulsiva”, affettiva”) e strumentale (“predatoria”, “subdola”)
    E.2.2Secondary objectives of the trial
    1) we will investigate the acute effects of medications, known to impact positively on aggression in the context of CD/ODD. In particular we aim to identify the acute effect of medication on specific neuropsychological and physiological features possibly underlying different types of aggression (reactive/instrumental aggression). For this purpose, we will specifically explore the responses to an acute medication challenge by the administration of a single dose of a stimulant, a not stimulant SNRI and two antipsychotic medications (Methylphenidate, Atomoxetine, Risperidone, Aripiprazole).

    2) We will evaluate the moderating or modulating role on the neuropsychological/autonomic response of the following variables: presence of Callous-unemotional traits, comorbidities, SES, age and gender, previous medication, source of information (patient, parents, teacher, clinician evaluation), family structure.
    1. Studiare gli effetti di una singola somministrazione di farmaci noti per il loro impatto positivo sull’aggressività nel contesto del CD/ODD. In particolare, l’obiettivo è quello di identificare i meccanismi cognitivi e fisiologici sottostanti le risposte ai farmaci, attraverso lo studio di specifiche funzioni neuropsicologiche e fisiologiche verosimilmente alla base dei differenti tipi di aggressività (reattiva vs strumentale) . A tal fine, indagheremo, nello specifico, le risposte a una singola somministrazione acuta di farmaco utilizzando uno stimolante (Metilfenidato), un non stimolante (Atomoxetina) e due antipsicotici (Risperidone e Aripiprazolo).

    2. Valutare il ruolo di moderatori o modulanti sulle risposte neuropsicologiche/autonomiche delle seguenti variabili: presenza di tratti calloso-anemozionali, comorbidità, livello socio-economico, età e sesso, precedenti terapie farmacologiche, fonti di informazione, struttura della famiglia.

    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    ODD/CD GROUP:

    - IQ = 80 (Wechsler IQ scale, within the last two years before enrolment);
    - Age between 10 years and 17 years and 10 month at the screening visit
    - Diagnosis of ODD or CD, based on the DSM-5 including the semi-structured K-SADS-PL interview;
    - Aggression in the clinical range, T = 70 on the aggression or delinquency subscale of the Teacher Report Form (TRF), Youth Self Report (YSR), or Child Behaviour Checklist (CBCL); or score = 27 on the Nisonger-CBRF D-Total (composite of Disruptive Behavior Disorder subscales);
    - The patient is eligible to be treated with a pharmacological therapy based on previous medical and instrumental cardiological assessments (personal and family cardiological history, ECG within the last six months; see 5.2.1.1) and based on previous blood chemistry (performed within the last six months), current physical and neurological examination;
    - Patient is drug-naive for psychotropic medications or off any psychotropic medication (Psychostimulants, antipsychotics, SNRI, mood stabilizers or antidepressant) within the last six months.
    - If the patient is a girl who is sexually active and of childbearing potential (WOCBP: Women of Childbearing Potential, defined as females aged =10 years old and younger girls who, at the discretion of the investigator, are deemed to be of reproductive potential), must have a negative urine pregnancy test at the Screening visit and at Baseline visit prior to randomization for phase III. The urine pregnancy test will be repeated, each week, during the randomised single-blind, placebo controlled, single dose, cross-over, acute challenge phase. The inclusion of WOCBP will require, throughout the study period, the use of condom and one of the following highly effective contraceptive measures: intrauterine devices, hormonal contraceptives (oral, depot, patch, injectable, or vaginal ring). ¿Other acceptable contraception methods are: ¿double barrier methods (e.g., condoms and diaphragms with spermicidal gel or foam).
    - Subjects’ parents/legal guardians must provide and sign informed consent documents; patients must provide informed consent, and sign consent or assent documents if capable and permitted according to the legal requirements in the country;
    - Patients meeting criteria for comorbid ADHD, Depression, Anxiety or PTSD (as to the clinical judgment of the investigator) will not be excluded from study participation.


    TYPICALLY DEVELOPING (TD) CONTROLS GROUP:

    - IQ = 80 (Wechsler IQ scale, within the last two years before enrolment);
    - Age between 10 years and 17 years and 10 month at the screening visit;
    - Aggression below the clinical range, T < 70 on the aggression or delinquency subscale of the Teacher Report Form (TRF), Youth Self Report (YSR), Child Behaviour Checklist (CBCL); and score < 27 on the Nisonger-CBRF D-Total (composite of Disruptive Behavior Disorder subscales);
    - Subjects have to be drug-naive for psychotropic medications;
    - Subjects’ parents/legal guardians must provide and sign informed consent documents; TD control must provide informed consent, and sign consent or assent documents if capable and permitted according to the legal requirements in each country;
    - Subjects meeting criteria for any psychiatric condition will be excluded from study participation.
    - If the patient is a girl who is sexually active and WOCBP, must have a negative urine pregnancy test at the Screening visit and at Baseline visit.
    GRUPPO ODD/CD:

    - QI = 80, misurato tramite scale Wechsler (e.g. WISC; WAIS) entro 2 anni dall’arruolamento nello studio) .
    - Età compresa tra i 10 anni e non più di 17 anni e 10 mesi alla visita -1 (visita di screening).
    - Diagnosi di ODD o CD, secondo il DSM-5 basata su una valutazione psichiatrica dettagliata [compresa l’intervista diagnostica semistrutturata Kiddie-SADS-Present and Lifetime – Diagnostic Interview (K-SADS-PL)].
    - Aggressività nel range clinico, T = 70 nella sottoscala aggressività o delinquenza del Teacher Report Form (TRF), Youth Self Report (YSR) o Child Behaviour Checklist (CBCL), oppure punteggio NCBRF-TIQ D-Total = 27 (derivato dalle sottoscale dei disturbi dirompenti del comportamento nella Nisonger CBRF-TIQ).
    - Il paziente risulta candidabile ad assumere una terapia farmacologica sulla base di accertamenti cardiologici strumentali e medici precedentemente eseguiti (anamnesi cardiologica personale e familiare, ECG eseguito negli ultimi sei mesi) e sulla base di precedenti esami ematici (routine ematochimica eseguita negli ultimi sei mesi) e dell’attuale esame obiettivo e esame neurologico)
    - Il paziente deve essere drug-naive per i farmaci psicotropi o aver interrotto qualsiasi farmaco psicotropo (psicostimolanti, antipsicotici, inibitori selettivi del reuptake della noradrenalina, stabilizzanti dell’umore o antidepressivi) negli ultimi sei mesi.
    - I genitori/tutori legali dei soggetti devono fornire il consenso e firmare i documenti di consenso informato; i pazienti devono fornire il consenso e firmare i documenti di consenso o assenso se capaci e autorizzati in base alle disposizioni di legge.
    - I pazienti che soddisfano i criteri per ADHD, Depressione, Ansia o DPTS in comorbidità (secondo il giudizio clinico dell’investigatore) non saranno esclusi dalla partecipazione allo studio.
    - Se il soggetto è una ragazza con vita sessuale attiva e in età fertile, al momento della visita di screening e al baseline, prima della randomizzazione alla fase III, dovrà sottoporsi a test di gravidanza urinario che dovrà risultare negativo. Tale test sarà poi ripetuto settimanalmente durante la fase di studio randomizzata, in singolo cieco, di somministrazione acuta di singola dose di farmaco, controllata verso placebo. Durante tutta la durata dello studio, la ragazza dovrà ricorrere a misure contraccettive altamente efficaci, quali l’uso di preservativi e una tra le seguenti: dispositivi intrauterini o contraccettivi ormonali (orali, depot, cerotto, iniettabili o anello vaglinale).¿ Altri metodi contraccettivi validi possono essere considerati i metodi di doppia barriera (es., preservativi e diaframma con gel o creme spermicide).

    GRUPPO CONTROLLI CON SVILUPPO TIPICO:

    - - QI = 80, misurato tramite scale Wechsler (e.g. WISC; WAIS) entro 2 anni dall’arruolamento nello studio)
    - Età compresa tra i 10 anni e non più di 17 anni e 10 mesi alla visita -1 (visita di screening).
    - Aggressività sotto il range clinico, T < 70 nella sottoscala aggressività o delinquenza del Teacher Report Form (TRF), Youth Self Report (YSR), Child Behaviour Checklist (CBCL) e punteggio NCBRF-TIQ D-Total < 27 (derivato dalle sottoscale dei disturbi dirompenti del comportamento nella Nisonger CBRF-TIQ).
    - Il soggetto deve essere drug-naive per i farmaci psicotropi.
    - Il soggetto di sesso femminile in età fertile deve risultare negativo al test di gravidanza al momento dello screening e dell’arruolamento.
    - I genitori/tutori legali dei soggetti devono fornire il consenso e firmare i documenti di consenso informato; i controlli con sviluppo tipico devono fornire il consenso informato, e firmare i documenti di consenso o assenso se capaci e autorizzati in base alle disposizioni di legge.
    - I soggetti che soddisfano i criteri per un qualsiasi disturbo psichiatrico saranno esclusi dallo studio.
    E.4Principal exclusion criteria
    ODD/CD GROUP:

    - IQ < 80 (Wechsler IQ scale, within the last two years before enrolment);
    - The subject has a primary DSM-5 diagnosis of schizophrenia-related disorders, schizophrenia, bipolar disorder, Autistic Spectrum Disorder, depression or anxiety;
    - The subject had any psychotropic medications (Psychostimulant, antipsychotics, SNRI, antidepressant, mood stabilizers) within the last six months before screening visit;
    - The subject is pregnant or nursing;
    - The subject has a body weight < 30 Kg
    - The subject has any acute or unstable medical condition that, in the opinion of the investigator, would compromise participation in the study. The patient will be excluded if presents with one or more of the following conditions: neurological disorder, other psychiatric disorder, cardiovascular disease, seizure disorder on encephalopathy, congestive heart failure, cardiac hypertrophy, arrhythmia, bradycardia (pulse<50bpm), respiratory disease, hepatic impairment or renal insufficiency, metabolic disorder, endocrinological disorder, gastrointestinal disorder, haematological disorder, infectious disorder, any clinically significant immunological condition, dermatological disorder, congenital or juvenile glaucoma or is at risk of acute narrow-angle glaucoma
    - The subject has a history of severe allergies to medications, in particular hypersensitivity to neuroleptics, or of multiple adverse drug reactions, or the patient has any contraindications to the use of the study drugs as following:
    Metilphenidate and Atomoxetine are contraindicated in patients known to be hypersensitive to these drugs or other components of the products; in patients with glaucoma; during treatment with monoamine oxidase inhibitors, and also within a minimum of 14 days following discontinuation of a monoamine oxidase inhibition; in patients with severe hypertension, angina pectoris, cardiac arrhythmias, heart failure, recent myocardial infarction, hyperthyroidism or thyrotoxicosis.
    Risperidone is contraindicated in patients with a known hypersensitivity to either risperidone or paliperidone, or to any of the excipients in the formulation.
    Aripiprazole is contraindicated in patients with a history of a hypersensitivity reaction to aripiprazole.
    Moreover Aripiprazole and Risperidone must be used with caution in subjects with a history of seizures, hypertension, angina pectoris, cardiac arrhythmias, heart failure, recent myocardial infarction, cerebrovascular adverse event, dyslipidemia and metabolic changes, a history of leukopenia, neutropenia, and agranulocytosis, or of hepatic impairment or renal insufficiency, neuroleptic malignant syndrome (NMS), diabetes, in patients with previous hyperprolactinemia, orthostatic hypotension suicidal thoughts and behaviors, alcohol abuse or dependence.


    TYPICALLY DEVELOPING (TD) CONTROLS GROUP:

    - IQ < 80 (Wechsler IQ scale, within the last two years before enrolment);
    - the subject has a primary DSM-5 diagnosis of ADHD, ODD, CD or any other psychiatric condition;
    - The subject had any psychotropic medications (Psychostimulant, antipsychotics, SNRI, antidepressant, mood stabilizers) within the last six months before screening visit.
    - The subject is pregnant or nursing.
    GRUPPO ODD/CD:

    - QI < 80, misurato tramite scale Wechsler (e.g. WISC; WAIS) entro 2 anni dall’arruolamento nello studio
    - Il soggetto ha una diagnosi primaria secondo il DSM-5 di disturbi correlabili alla schizofrenia, disturbo bipolare, disturbo dello spettro autistico, depressione o ansia
    - Il soggetto ha assunto un qualsiasi farmaco psicotropo (psicostimolanti, antipsicotici, inibitori selettivi del reuptake della noradrenalina, stabilizzanti dell’umore o antidepressivi) negli ultimi sei mesi prima della visita di screening
    - Il soggetto ha una qualsiasi condizione medica acuta o instabile che, secondo l’opinione dell’investigatore, comprometterebbe la partecipazione nello studio. Il paziente verrà escluso in caso presenti una delle seguenti condizioni: patologia neurologica, disturbi convulsivi o encefalopatia, insufficienza cardiaca congestizia, ipertrofia cardiaca, aritmie cardiache, bradicardia (frequenza<50bpm), patologia respiratoria, insufficienza epatica o insufficienza renale, malattia metabolica, disturbi endocrinologici, patologie gastrointestinali, disordini ematologici, patologie infettive, qualsiasi condizione clinicamente significativa di disordine immunologico, disturbi dermatologici, glaucoma congenito o giovanile o è a rischio di glaucoma acuto ad angolo stretto
    - Il soggetto ha una storia di gravi allergie a farmaci, in particolare ipersensibilità a neurolettici, o una storia di multiple reazioni avverse al farmaco o il paziente presenta una qualsiasi controindicazione all’utilizzo dei farmaci dello studio.
    Il Metilfenidato e l’Atomoxetina sono controindicati nei pazienti con ipersensibilità nota a questi farmaci o altri componenti dei prodotti; in pazienti con glaucoma; durante il trattamento con inibitori della monoaminossidasi (MAO-I), nonché nei primi 14 giorni dopo l'interruzione di un eventuale terapia con MAO-I; nei -pazienti affetti da grave ipertensione, angina pectoris, aritmie cardiache, insufficienza cardiaca, infarto miocardico recente, ipertiroidismo o tireotossicosi.
    Il Risperidone è controindicato in pazienti con nota ipersensibilità a risperidone o paliperidone, o ad uno qualsiasi degli eccipienti nella formulazione.
    L’Aripiprazolo è controindicato nei pazienti con una storia di pregressa reazione di ipersensibilità ad aripiprazolo. Inoltre Aripiprazolo e Risperidone devono essere usati con cautela nei soggetti con una storia di convulsioni, ipertensione, angina pectoris, aritmie cardiache, insufficienza cardiaca, infarto miocardico recente, eventi avversi cerebrovascolari, dislipidemia e cambiamenti metabolici, leucopenia, neutropenia, e agranulocitosi o di insufficienza epatica o renale, sindrome neurolettica maligna (NMS), diabete, nei pazienti con pregressa iperprolattinemia, ipotensione ortostatica pensieri e comportamenti suicidi, abuso di alcool o dipendenza.
    - Il soggetto è in stato di gravidanza o in allattamento
    - Il soggetto ha un peso corporeo < 30 Kg.

    GRUPPO CONTROLLI CON SVILUPPO TIPICO:

    - QI < 80, misurato tramite scale Wechsler (e.g. WISC; WAIS) entro 2 anni dall’arruolamento nello studio
    - Il soggetto ha una diagnosi primaria secondo il DSM-5 di of ADHD, ODD, CD o qualsiasi altra condizione psichiatrica
    - Il soggetto ha assunto un qualsiasi farmaco psicotropo (psicostimolanti, antipsicotici, inibitori selettivi del reuptake della noradrenalina, stabilizzanti dell’umore o antidepressivi) negli ultimi sei mesi prima della visita di screening
    - Il soggetto è in stato di gravidanza o in allattamento
    E.5 End points
    E.5.1Primary end point(s)
    1) Reaction times, accuracy, test completion, learning rate, response latency, motivation, cooperation, reward-punishment sensitivity, attention, working memory, decision making, risk evaluation, social cognition, delay aversion, emotional processing on the neuropsychological tasks from CANTAB and EMOTICOM batteries:
    • Intra-Extra Dimensional Set Shift (IED) [only baseline] - CANTAB
    • Face and Eyes Emotional Recognition Task [only baseline] - EMOTICOM
    • Delay Discounting [only baseline] - EMOTICOM
    • Moral Judgment [only baseline] - EMOTICOM
    • Prisoners Dilemma [only baseline] - EMOTICOM
    • Rapid Visual Information Processing (RVP) - CANTAB
    • Delayed Matching to Sample (DMtS) - CANTAB
    • Progressive Ratio Task - EMOTICOM
    • Face Affective Go/NoGo - EMOTICOM
    • New Cambridge Gambling Task - EMOTICOM
    • Reinforcement Learning Task - EMOTICOM
    • Theory of Mind - EMOTICOM
    • Ultimatum Game – EMOTICOM

    2) Autonomic measuraments at rest and during test performance:
    - heart rate and skin conductance, by a wristband able to record Heart Rate (HR) and Heart Rate Variability by a Photoplethysmography technique. HR will be recorded for five minutes while the participant will be at rest to yield baseline and continuously during the performance of the whole neuropsychological battery. The same wristband will allow to record the electrodermal activity in terms of Skin conductance (referred to as Galvanic Skin Response) Arousal and Excitement.
    - salivary cortisol levels using a "passive drool" method
    1) Tempi di reazione, accuratezza, completamento del test, tasso di apprendimento, latenza di risposta, motivazione, cooperazione, sensibilita` a premi/ricompense, attenzione, memoria di lavoro, decision making, valutazione del rischio, cognizione sociale, avversione per l'attesa e processamento delle emozioni misurati attraverso i task neuropsicologici della batteria CANTAB e della batteria EMOTICOM:
    • Intra-Extra Dimensional Set Shift (IED) [solo al baseline] - CANTAB
    • Face and Eyes Emotional Recognition Task [solo al baseline] - EMOTICOM
    • Delay Discounting [solo al baseline] - EMOTICOM
    • Moral Judgment [solo al baseline] - EMOTICOM
    • Prisoners Dilemma [solo al baseline] - EMOTICOM
    • Rapid Visual Information Processing (RVP) - CANTAB
    • Delayed Matching to Sample (DMtS) - CANTAB
    • Progressive Ratio Task - EMOTICOM
    • Face Affective Go/NoGo - EMOTICOM
    • New Cambridge Gambling Task - EMOTICOM
    • Reinforcement Learning Task - EMOTICOM
    • Theory of Mind - EMOTICOM
    • Ultimatum Game – EMOTICOM

    2) Misure autonomiche:
    • Frequenza cardiaca e conduttanza cutanea: i partecipanti indosseranno un apposito bracciale da polso per la misurazione del profilo autonomico. Il bracciale consente di registrare la frequenza cardiaca e la relativa variabilita` attraverso una tecnica fotopletismografica. La frequenza cardiaca sara` misurata a riposo per cinque minuti e continuativamente durante l'esecuzione di tutta la batteria di test neuropsicologici. Lo stesso bracciale consentira` di registrare l'attivita` elettrodermica in termini di conduttanza cutanea (risposta cutanea galvanica), attivazione ed eccitamento.
    • Cortisolo salivare
    E.5.1.1Timepoint(s) of evaluation of this end point
    CD/ODD and TD will undergo a BASELINE assessment with a neuropsychological testing battery in 2 subsequent days. Testing will be split up into 3 sessions. First session (4 tasks) will be administered during the first day. Second (5 tasks) and third session (4 tasks) will be administered during the second day.
    CD/ODD will be then enrolled in one of the 2 randomised single-blind, placebo controlled, single dose, cross-over, acute challenge studies. A subset of the tasks will be administered after the administration of a single dose of 1 of the 4 selected medications or placebo, once a week for 3 consecutive weeks.
    Subjects will be assessed on autonomic measures (HR, skin conductance, salivary cortisol) before, during and/or after the testing sessions.
    CD/ODD e TD saranno sottoposti a una valutazione BASELINE con una batteria di test neuropsicologici suddivisi in 3 sessioni in 2 giorni consecutivi. La prima sessione (4 task) sara` somministrata il primo giorno, la seconda (5 task) e la terza (4 task) il secondo giorno. CD/ODD saranno poi arruolati in uno dei 2 bracci di somministrazione di singola dose di farmaco, cross-over, randomizzati in singolo cieco e controllati verso placebo. Parte dei test sara` somministrata a ogni soggetto dopo l'assunzione di singola dose di uno dei 4 farmaci selezionati o placebo, una volta alla settimana per 3 settimane consecutive.
    I soggetti saranno anche sottoposti alla valutazione di specifiche misure autonomiche (FC, conduttanza cutanea, cortisone salivare) prima, durante e/o dopo le sessioni test.
    E.5.2Secondary end point(s)
    The following measures will be used to investigate the association between severity, type of aggression and performance on the neuropsychological tasks:
    • screening questionnaires: Teacher Report Form (TRF), Youth Self Report (YSR), Child Behavior Checklist (CBCL), The Conners’ Parent Rating Scale-Revised (CPRS-RS), Behavior Rating Inventory of Executive Function (BRIEF), Inventory of Callous-Unemotional Traits (ICU)
    • screening rating scales: Modified Overt Aggression Scale (MOAS) and Nisonger Child Behavior Rating Form Typical IQ version (NCBRF-TIQ) interview
    • Clinical Global Impression-Severity (CGI-S), Children’s Global Assessment (C-GAS)
    Le seguenti misure saranno utilizzate per indagare l’associazione tra severità, tipo di aggressività e performance nei task neuropsicologici:
    • questionari di screening: Teacher Report Form (TRF), Youth Self Report (YSR), Child Behavior Checklist (CBCL), The Conners’ Parent Rating Scale-Revised (CPRS-RS), Behavior Rating Inventory of Executive Function (BRIEF), Inventory of Callous-Unemotional Traits (ICU)
    • rating scales di screening: Modified Overt Aggression Scale (MOAS) e l'intervista Nisonger Child Behavior Rating Form Typical IQ version (NCBRF-TIQ)
    • Clinical Global Impression-Severity (CGI-S), Children’s Global Assessment (C-GAS)
    E.5.2.1Timepoint(s) of evaluation of this end point
    Secondary endpoints will be assessed during the screening visit.
    Gli endpoint secondari saranno valutati durante la visita di screening.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety No
    E.6.5Efficacy No
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Neuropsychological characterization of aggressive behavior in children and adolescents with Conduct Disorder or Oppositional Defiant Disorder


    Caratterizzazione neuropsicologica dell'aggressività in bambini e adolescenti affetti da Disturbo della Condotta o Disturbo Oppositivo Provocatorio
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind Yes
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over Yes
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial7
    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 Yes
    E.8.4.1Number of sites anticipated in Member State concerned2
    E.8.5The trial involves multiple Member States No
    E.8.5.1Number of sites anticipated in the EEA2
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.7Trial has a data monitoring committee Yes
    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
    LVLS
    Ultima visita dell'ultimo paziente (LVLS)
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months12
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years0
    E.8.9.2In all countries concerned by the trial months12
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) Yes
    F.1.1.5.1Number of subjects for this age range: 32
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 128
    F.1.2Adults (18-64 years) No
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers Yes
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state160
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 160
    F.4.2.2In the whole clinical trial 160
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    none
    nessuno
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    G.4.1Name of Organisation MATRICS CONSORTIUM
    G.4.3.4Network Country Netherlands
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2017-07-04
    N.Ethics Committee Opinion of the trial application
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion
    P. End of Trial
    P.End of Trial Status
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