E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Attention-deficit hyperactivity disorder (ADHD) |
ADHD |
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E.1.1.1 | Medical condition in easily understood language |
ADHD: hyperactivity and/or low concentration |
ADHD: hyperactiviteit en/of gebrek aan concentratie |
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E.1.1.2 | Therapeutic area | Psychiatry and Psychology [F] - Mental Disorders [F03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003737 |
E.1.2 | Term | Attention deficit/hyperactivity disorder NOS |
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 | 19.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10003736 |
E.1.2 | Term | Attention deficit/hyperactivity 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 | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003735 |
E.1.2 | Term | Attention deficit-hyperactivity 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 | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003734 |
E.1.2 | Term | Attention deficit disorder of childhood without mention of hyperactivity |
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 | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003733 |
E.1.2 | Term | Attention deficit disorder of childhood with hyperactivity |
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 | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003732 |
E.1.2 | Term | Attention deficit disorder of childhood |
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 | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003731 |
E.1.2 | Term | Attention deficit 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 | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003729 |
E.1.2 | Term | Attention concentration difficulty |
E.1.2 | System Organ Class | 100000004852 |
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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 |
To assess the efficacy of Pycnogenol® for improving ADHD and ADD behaviour as rated by parents as compared to placebo and Medikinet Retard. |
Het onderzoeken van het effect van Pycnogenol op ADHD of ADD gedrag beoordeeld door ouders, vergeleken met placebo en Medikinet Retard. |
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E.2.2 | Secondary objectives of the trial |
To assess the efficacy of Pycnogenol® for improving ADHD and ADD behavior as rated by teachers as compared to placebo and Medikinet Retard. To evaluate the effect of Pycnogenol® as compared to placebo and Medikinet Retard on immunity, antioxidant levels, oxidative damage and comorbid psychiatric/physical complaints; To evaluate the tolerability of Pycnogenol®. |
Het onderzoeken van het effect van Pycnogenol op ADHD of ADD gedrag beoordeeld door leerkrachten, vergeleken met placebo en Medikinet Retard. Het beoordelen van de effecten van Pycnogenol, in vergelijking met placebo en Medikinet retard, op immuniteit, antioxidant status, oxidatieve schade, and co-morbide psychiatrische en fysieke klachten. Het beoordelen van de verdraagbaarheid van Pycnogenol. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
The patient is between 6-12 years old (both inclusive). The patient satisfies the DSM-IV criteria for ADHD or ADD. The patient does not have any contraindication for the use of methylphenidate. The patient has a responsible caregiver who is able to provide information about the patient’s functional status. Written informed consent is obtained from the patient and the legally accepted representative. |
De patiënt is 6-12 jaar oud (incl.). De patiënt beantwoordt aan de DSM-IV criteria voor ADHD of ADD. The patiërnt heeft geen contraindicatie voor het gebruik van methylfenidaat. De patiënt heeft een verantwoordelijke die informatie kan geven over de functionele status van de patiënt. Geschreven geïnformeerde toestemming is bekomen van de patiënt en zijn/haar wettelijke vertegenwoordiger. |
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E.4 | Principal exclusion criteria |
The patient was diagnosed with autism spectrum disorder. The patient does have situational hyperactivity, pervasive developmental disorders, schizophrenia, other psychotic disorders such as mood or anxiety disorder, personality disorder as unsocial behaviour, personality change due to a general medical condition, mental retardation (IQ < 70), understimulating environments, conduct disorder, chorea and other dyskinesias. The patient does have tics or Tourette's syndrome, or personal or family history of psychotic disorder, bipolar illness, depression, or suicide attempt. The patient does have any chronic medical disorder (diabetes, epilepsy or other seizure disorder, autoimmune disorder, gastrointestinal disorder, renal or cardiovascular disorders, etc.) or acute inflammatory disease. The patient does have glaucoma, heart disease, heart rhythm disorder, high blood pressure, or peripheral vascular disease such as Raynaud's syndrome. The patient did use any of these medications during the 3 months before entering the study: clonidine, guanethidine, blood thinners (e.g. warfarin or Coumadin), antidepressants (e.g. amitriptyline, citalopram, doxepin, fluoxetine, nortriptyline, paroxetine, sertraline), cold or allergy medicine that contains a decongestant, medications to treat high or low blood pressure, seizure medicine (e.g. phenobarbital, phenytoin, primidone), or diet pills. The patient did take MAO inhibitor (isocarboxazid, linezolid, phenelzine, rasagiline, selegiline or tranylcypromine) in the past 14 days. The patient did use vitamin/mineral/herbal/omega-3 supplements or other any medication (psychoactive medication, antibiotics, anti-inflammatory drugs, melatonin, etc.) > 1 week during the 3 months before inclusion. |
De patiënt kreeg de diagnose van autisme spectrum stoornis. De patiënt heeft situationele hyperactiviteit, pervasieve ontwikkelingsstoornis, schizofrenie, andere psychotische aandoeningen zoals stemmings- of angststoornissen, persoonlijkheidsstoornis zoals asociaal egdrag, persoonlijkheidsverandering door een medische aandoening, mentale achterstand (IQ < 70), onderstimulerende omgeving, antisociale stoornis, chorea and andere dyskinesie. De patiënt heeft tics of het syndroom van Tourette, of persoonlijke of familiale geschiedenis van psychotische aandoeningen, bipolaire stoornis, depressie, of zelfmoordpoging. De patiënt heeft een chronische medische aandoening (diabetes, epilepsie of andere aanvalsstoornis, autoimmuunziekte, maagdarmstoornis, nier- of cardiovasculaire aandoening, etc.) of acute ontstekingsziekte. De patiënt heeft glaucoom, hartaandoening, hartritmestoornis, hoge bloeddruk, of perifere vasculaire aandoening zoals het syndroom van Raynaud. De patiënt heeft een of meerdere van deze medicaties gebruikt tijdens de drie maanden voorafgaan aan de studie: clonidine, guanethidine, bloedverdunners (bv. warfarine of Coumarine), antidepressiva, medicatie voor verkoudheden of allergie met decongestivum, medicatie voor hoge of lage bloeddruk, aanvalsmedicatie (bv. phenobarbital, phenytoin, primidone), of dieetpillen. De patiënt nam MAO remmer (isocarboxazid, linezolid, phenelzine, rasagiline, selegiline of tranylcypromine) tijden de voorbije 14 dagen. De patiënt nam vitamine/mineralen/kruiden/omega-3 supplementen of enige andere medicatie (psychoactieve medicatie, antibiotica, ontstekingsremmende medicatie, melatonine, etc.) gedurende langer dan 1 week tijden de 3 maanden voorafgaan aan de studie. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Summed ADHD score of the ADHD-Rating Scale (ADHD-RS) as rated by parents. |
Totale ADHD-score van de ADHD-Rating Scale (ADHD-RS) zoals beoordeeld door ouders. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
5 week, 10 weeks |
5 weken, 10 weken |
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E.5.2 | Secondary end point(s) |
Summed ADHD score of the ADHD-RS as rated by teachers Summed ADHD score of the Social-Emotional Questionnaire (SEQ) as rated by parents & teachers Scores on ADHD subscales of the ADHD-RS and SEQ as rated by parents and teachers – hyperactivity, impulsivity and inattention Percentage of responders as rated by parents and teachers: Responders will be defined as participants with a reduction of at least 20% on their baseline summed ADHD score of the ADHD-RS. Social behavior problems subscale of the Social-Emotional Questionnaire (SEQ), as rated by parents and teachers Anxiety subscale of the Social-Emotional Questionnaire (SEQ), as rated by parents and teachers Physical and sleep complaints as measured by the Physical Complaints Questionnaire (PCQ) Erythrocyte glutathione (GSH) level: GSH is the most important intracellular antioxidant. Urinary 8-OHdG level: a marker of oxidative DNA damage. Plasma malondialdehyde (MDA) level: marker of in vivo oxidative lipid peroxidation. Immune profiling: Immune system activation state, skewing and responsivity will be assessed by the following determinations: determination of plasma cytokine levels for monocytes and T-cells as well as antibody levels. Gene expression quantification by RT-qPCR, focusing on gene and protein networks counteracting oxidative stress (GPX, CAT, SOD, XO) and stress-related proteins (Clusterin, Apolipoprotein J) Serum neuropeptide Y levels Serum zinc Plasma lipid soluble vitamins Urinary catecholamines Intestinal microbial composition Dietary habits Intervention acceptability |
Totale ADHD-score van de ADHD-RS, beoordeeld door leerkrachten Totale ADHD-score van de Sociaal-Emotionele vragenlijst (SEV), beoordeeld door ouders en leerkrachten Scoren op ADHD subschalen van de ADHD-RS en SEV, beoordeeld door ouders en leerkrachten: hyperactiviteit, impulsiviteit en concentratie. Percentage responders (vermindering totale ADHD-RS score van minstens 20%, beoordeeld door ouders en leerkrachten) Sociale gedragsproblemen subschaal van de SEV, beoordeeld door ouders en leerkrachten Angst subschaal van de SEV, beoordeeld door ouders en leerkrachten Fysieke en psychische klachten, gemeten door de Fysieke Klachten Vragenlijst Erytrocyten glutathione (GSH) niveau, de belangrijkste intracellulaire antioxidant Urine 8-OHdG niveau, een merker van oxidatieve schade aan DNA Plasma MDA niveau, een merker van in vivo oxidatieve schade aan vetten Immuunprofiel: immuun activatie, neiging, en responsiviteit door bepaling van plasma cytokine (monocyten en T cellen) en antilichaam niveau Genexpressie kwantificatie toor RT-qPCR, met de focus op genen tegen oxidatieve stress (GPX, CAT, SOD, XO) en stress-gerelateerde eiwitten (Clusterin, Apolipoprotein J) Serum neuropeptide Y niveau Serum zinc Plasma vetoplosbare vitaminestatus Urinair catecholamine niveau Intestinale microbiële samenstelling Voedingsgewoonten Aanvaardbaarheid van de interventie |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
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) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |