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    Clinical Trial Results:
    An Open-Label Study To Evaluate The Safety Of Donepezil Hydrochloride (Aricept) For Up To 1 Year In The Treatment Of The Cognitive Dysfunction Exhibited By Children With Down Syndrome - Follow-Up To A 10-Week, Double-Blind, Placebo-Controlled Trial

    Summary
    EudraCT number
    2016-004947-35
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    15 Dec 2008

    Results information
    Results version number
    v1(current)
    This version publication date
    23 May 2021
    First version publication date
    23 May 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    E2020-A001-220
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00675025
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Eisai Medical Research Inc.
    Sponsor organisation address
    100 Tice Boulevard, Woodcliff Lake, New Jersey, United States, 07677
    Public contact
    Eisai Medical Information, Eisai Inc., 888 274-2378, esi-medinfo@eisai.com
    Scientific contact
    Eisai Medical Information, Eisai Inc., 888 274-2378, esi-medinfo@eisai.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    15 Dec 2008
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Dec 2008
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The purpose of this study is to determine the safety of donepezil hydrochloride (Aricept) in children with Down syndrome who have finished the preceding 10-week, double-blind study of donepezil hydrochloride. Medical tests for drug safety will be conducted at each clinic visit.
    Protection of trial subjects
    This study was conducted in accordance with standard operating procedures (SOPs) of the sponsor (or designee), which are designed to ensure adherence to Good Clinical Practice (GCP) guidelines as required by the following: - Principles of the World Medical Association Declaration of Helsinki (World Medical Association, 2008) - International Council on Harmonisation (ICH) E6 Guideline for GCP (CPMP/ICH/135/95) of the European Agency for the Evaluation of Medicinal Products, Committee for Proprietary Medicinal Products, International Council for Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use - Title 21 of the United States (US) Code of Federal Regulations (US 21 CFR) regarding clinical studies, including Part 50 and Part 56 concerning informed subject consent and Institutional Review Board (IRB) regulations and applicable sections of US 21 CFR Part 312 - European Good Clinical Practice Directive 2005/28/EC and Clinical Trial Directive 2001/20/EC for studies conducted within any European Union (EU) country. All suspected unexpected serious adverse reactions were reported, as required, to the Competent Authorities of all involved EU member states. - Article 14, Paragraph 3, and Article 80-2 of the Pharmaceutical Affairs Law (Law No. 145, 1960) for studies conducted in Japan, in addition to Japan’s GCP Subject Information and Informed Consent.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    04 Apr 2008
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 117
    Worldwide total number of subjects
    117
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    113
    Adults (18-64 years)
    4
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This study was recruited at 24 centers in the United States during the period of 04 Apr 2008 to 15 Dec 2008. All subjects who completed the double-blind (DB) placebo-controlled, 10 week study (Study 2020-A001-219 [NCT00570128]) were offered enrollment in this study.

    Pre-assignment
    Screening details
    The Screening and baseline activities for this study took place on the same day as the Week 10 final visit of the double-blind (DB) study (2020-A001-219 [NCT00570128]).

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Prior Donepezil-DB
    Arm description
    Subjects who received donepezil in the double-blind study E2020-A001-219 (NCT00570128) were continued in this OLE study to be treated with donepezil titrated to achieve a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL for up to approximately Week 42.
    Arm type
    Experimental

    Investigational medicinal product name
    Donepezil Hydrochloride
    Investigational medicinal product code
    Other name
    Aricept
    Pharmaceutical forms
    Oral liquid
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects received donepezil titrated to a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL.

    Arm title
    Prior Placebo-DB
    Arm description
    Subjects who received matched placebo in the double-blind study E2020-A001-219 (NCT00570128) were continued in this OLE study to be treated with donepezil titrated to achieve a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL for up to approximately Week 42.
    Arm type
    Experimental

    Investigational medicinal product name
    Donepezil Hydrochloride
    Investigational medicinal product code
    Other name
    Aricept
    Pharmaceutical forms
    Oral liquid
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects received donepezil titrated to a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL.

    Number of subjects in period 1
    Prior Donepezil-DB Prior Placebo-DB
    Started
    54
    63
    Completed
    0
    0
    Not completed
    54
    63
         Consent withdrawn by subject
    4
    6
         Adverse event, non-fatal
    6
    11
         Study Terminated by Sponsor
    38
    42
         Lost to follow-up
    6
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Prior Donepezil-DB
    Reporting group description
    Subjects who received donepezil in the double-blind study E2020-A001-219 (NCT00570128) were continued in this OLE study to be treated with donepezil titrated to achieve a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL for up to approximately Week 42.

    Reporting group title
    Prior Placebo-DB
    Reporting group description
    Subjects who received matched placebo in the double-blind study E2020-A001-219 (NCT00570128) were continued in this OLE study to be treated with donepezil titrated to achieve a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL for up to approximately Week 42.

    Reporting group values
    Prior Donepezil-DB Prior Placebo-DB Total
    Number of subjects
    54 63 117
    Age categorical
    Individual subject ages were not available for this study so the categorical age breakdown in the Trial Information Section could not be populated. Instead, all subjects were reported in the ‘Adolescents (12-17 years)’ category with the exception of four subjects who was aged over 17 years. The categorical age breakdown available (10 to 13 years, 14 to 17 years and >17 years) is reported below.
    Units: subjects
        10 to 13 years
    32 36 68
        14 to 17 years
    20 25 45
        >17 years
    2 2 4
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    13.4 ( 2.4 ) 13.2 ( 2.2 ) -
    Gender categorical
    Units: Subjects
        Female
    23 34 57
        Male
    31 29 60
    Race
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    0 4 4
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    2 3 5
        White
    46 55 101
        More than one race
    0 0 0
        Unknown or Not Reported
    6 1 7

    End points

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    End points reporting groups
    Reporting group title
    Prior Donepezil-DB
    Reporting group description
    Subjects who received donepezil in the double-blind study E2020-A001-219 (NCT00570128) were continued in this OLE study to be treated with donepezil titrated to achieve a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL for up to approximately Week 42.

    Reporting group title
    Prior Placebo-DB
    Reporting group description
    Subjects who received matched placebo in the double-blind study E2020-A001-219 (NCT00570128) were continued in this OLE study to be treated with donepezil titrated to achieve a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL for up to approximately Week 42.

    Primary: Change From Visit 1 (Baseline) to Visit 4 (or Early Termination) in the Vineland Adaptive Behavior Scales, 2nd Edition, Parent/Caregiver Rating Form (VABS-II/PCRF) Sum of the 9 Sub-domain V-scores

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    End point title
    Change From Visit 1 (Baseline) to Visit 4 (or Early Termination) in the Vineland Adaptive Behavior Scales, 2nd Edition, Parent/Caregiver Rating Form (VABS-II/PCRF) Sum of the 9 Sub-domain V-scores [1]
    End point description
    VABS-II/PCRF assessed subject's adaptive behaviors on 3 domains (each has 3 sub-domains): Communication (receptive, expressive, written), Daily Living Skills (personal, domestic, community), Socialization (interpersonal relationships, play a leisure time, coping skills). Parent/caregiver rated subject's behavior for sub-domains from 0 (never present) to 2 (always present). Raw scores from sub-domains converted into standardized score(V-scale scores) ranged:1-24 for each sub-domain, mean=15,standard deviation(SD)=3,higher scores=higher level of adaptive functioning and were summed to obtain V-scale composite score ranged 9-216, mean=100,SD=15,higher scores=higher level of adaptive functioning, positive change=improvement in adaptive functioning. Composite and individual analyses, both raw and standardized scores, were not performed due to lack of significant differences between donepezil and placebo in parent study. Analyses was performed on the Intent-to-treat population.
    End point type
    Primary
    End point timeframe
    Visit 1 (Baseline); Visit 4 (Week 42)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive data were planned to be analyzed for this endpoint.
    End point values
    Prior Donepezil-DB Prior Placebo-DB
    Number of subjects analysed
    54
    63
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Baseline (Week 10 of DB study)
    87.73 ( 16.58 )
    92.02 ( 17.51 )
        Early termination visit
    89.37 ( 16.58 )
    91.25 ( 18.45 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to early termination visit (Week 36)
    Adverse event reporting additional description
    Individual counts of non-serious adverse events (SAEs) were not available for this study, so the minimum number of events (i.e. the number of subject's experiencing an event) has been reported. Occurrences of non-SAEs may potentially have been higher than reported if one subject experienced the same event more than once.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    11.1
    Reporting groups
    Reporting group title
    Prior Donepezil-DB
    Reporting group description
    Subjects received donepezil titrated to a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL.

    Reporting group title
    Prior Placebo-DB
    Reporting group description
    Subjects received donepezil titrated to a final dose of 0.1 - 0.2 mg/kg/day using liquid formulated at 5 mg/5 mL.

    Serious adverse events
    Prior Donepezil-DB Prior Placebo-DB
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 63 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    Prior Donepezil-DB Prior Placebo-DB
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    37 / 54 (68.52%)
    48 / 63 (76.19%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 54 (1.85%)
    4 / 63 (6.35%)
         occurrences all number
    1
    4
    Somnolence
         subjects affected / exposed
    4 / 54 (7.41%)
    1 / 63 (1.59%)
         occurrences all number
    4
    1
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    1 / 54 (1.85%)
    3 / 63 (4.76%)
         occurrences all number
    1
    3
    Pyrexia
         subjects affected / exposed
    1 / 54 (1.85%)
    3 / 63 (4.76%)
         occurrences all number
    1
    3
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    2 / 54 (3.70%)
    1 / 63 (1.59%)
         occurrences all number
    2
    1
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    5 / 54 (9.26%)
    4 / 63 (6.35%)
         occurrences all number
    5
    4
    Diarrhoea
         subjects affected / exposed
    8 / 54 (14.81%)
    15 / 63 (23.81%)
         occurrences all number
    8
    15
    Flatulence
         subjects affected / exposed
    0 / 54 (0.00%)
    2 / 63 (3.17%)
         occurrences all number
    0
    2
    Frequent bowel movements
         subjects affected / exposed
    0 / 54 (0.00%)
    2 / 63 (3.17%)
         occurrences all number
    0
    2
    Nausea
         subjects affected / exposed
    2 / 54 (3.70%)
    4 / 63 (6.35%)
         occurrences all number
    2
    4
    Vomiting
         subjects affected / exposed
    4 / 54 (7.41%)
    4 / 63 (6.35%)
         occurrences all number
    4
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    0 / 54 (0.00%)
    4 / 63 (6.35%)
         occurrences all number
    0
    4
    Nasal congestion
         subjects affected / exposed
    0 / 54 (0.00%)
    4 / 63 (6.35%)
         occurrences all number
    0
    4
    Oropharyngeal pain
         subjects affected / exposed
    0 / 54 (0.00%)
    2 / 63 (3.17%)
         occurrences all number
    0
    2
    Rhinitis allergic
         subjects affected / exposed
    3 / 54 (5.56%)
    1 / 63 (1.59%)
         occurrences all number
    3
    1
    Wheezing
         subjects affected / exposed
    0 / 54 (0.00%)
    2 / 63 (3.17%)
         occurrences all number
    0
    2
    Skin and subcutaneous tissue disorders
    Furuncle
         subjects affected / exposed
    2 / 54 (3.70%)
    1 / 63 (1.59%)
         occurrences all number
    2
    1
    Rash
         subjects affected / exposed
    0 / 54 (0.00%)
    2 / 63 (3.17%)
         occurrences all number
    0
    2
    Psychiatric disorders
    Abnormal behaviour
         subjects affected / exposed
    1 / 54 (1.85%)
    3 / 63 (4.76%)
         occurrences all number
    1
    3
    Aggression
         subjects affected / exposed
    0 / 54 (0.00%)
    2 / 63 (3.17%)
         occurrences all number
    0
    2
    Initial insomnia
         subjects affected / exposed
    2 / 54 (3.70%)
    0 / 63 (0.00%)
         occurrences all number
    2
    0
    Irritability
         subjects affected / exposed
    3 / 54 (5.56%)
    1 / 63 (1.59%)
         occurrences all number
    3
    1
    Infections and infestations
    Ear infection
         subjects affected / exposed
    1 / 54 (1.85%)
    2 / 63 (3.17%)
         occurrences all number
    1
    2
    Gastroenteritis viral
         subjects affected / exposed
    0 / 54 (0.00%)
    2 / 63 (3.17%)
         occurrences all number
    0
    2
    Nasopharyngitis
         subjects affected / exposed
    2 / 54 (3.70%)
    0 / 63 (0.00%)
         occurrences all number
    2
    0
    Pharyngitis streptococcal
         subjects affected / exposed
    2 / 54 (3.70%)
    0 / 63 (0.00%)
         occurrences all number
    2
    0
    Sinusitis
         subjects affected / exposed
    6 / 54 (11.11%)
    8 / 63 (12.70%)
         occurrences all number
    6
    8
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 54 (3.70%)
    7 / 63 (11.11%)
         occurrences all number
    2
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    23 Jun 2008
    The following administrative changes were identified and were made to the Protocol 111 Amendment 01 after the original (19 Dec 2007) protocol was finalized: 1. Header, footer, and title page changed to reflect new amendment date and version. 2. Pfizer Study Manager was changed (Protocol Sections 1.3 and 15). 3. Person's title was changed (Protocol Sections 1.3 and 15). 4. Typographic error in second paragraph corrected; changed from "will be given in a final protocol appendix" to "is in Appendix II" (Protocol Section 9.7). 5. Typographic error in last bullet point corrected; changed from "16 weeks" to "18 weeks" (Protocol Section 10.3 .5). 6. Concomitant medication list revised to reflect changes in concomitant medication allowed and not allowed during the study (Protocol Appendix II).

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    This was an open-label trial that was terminated early by the Sponsor. Sufficient evidence of efficacy not met. Discontinuation was not based on any safety concerns.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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