Efficacy and Safety of SHP465 at 6.25 mg in the Treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in Children Aged 6-12 Years

A Phase 3, Randomized, Double-blind, Multicenter, Placebo-controlled, Fixed-Dose, Efficacy, and Safety Study of SHP465 in Children Aged 6-12 Years With Attention-Deficit/Hyperactivity Disorder (ADHD)

The purpose of this study is to evaluate the efficacy and safety of SHP465 at 6.25 mg in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children aged 6-12 years.

Study Overview

• Status: Completed
• Conditions: Attention Deficit Hyperactivity Disorder (ADHD)
• Intervention / Treatment: Drug: SHP465; Drug: Placebo

• Study Type: Interventional
• Enrollment (Actual): 89
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Dothan, Alabama, United States, 36303
      • Harmonex Neuroscience Research
  • Arkansas
    • Little Rock, Arkansas, United States, 72211
      • PEWMD, PA, ARCSM, PLLC, PRP, Inc.
  • California
    • Anaheim, California, United States, 92805
      • Advanced Research Center
    • Riverside, California, United States, 92506
      • Riverside Medical Clinic
    • Rolling Hills, California, United States, 90274
      • Peninsula Research Associates - CRN
  • Florida
    • Doral, Florida, United States, 33166
      • Care Research Center
    • Hialeah, Florida, United States, 33012
      • Power MD Clinical Research Institute
    • Jacksonville, Florida, United States, 32256
      • Clinical Neuroscience Solutions, Inc.
    • Miami, Florida, United States, 33142
      • Acevedo Medical Group
    • Miami, Florida, United States, 33175
      • Pharmacology Research, LLC
    • North Miami, Florida, United States, 33161
      • Scientific Clinical Research Inc.
    • Orlando, Florida, United States, 32801
      • Clinical Neuroscience Solutions, Inc.
    • Orlando, Florida, United States, 32806
      • Clinical Associates of Orlando, LLC
  • Georgia
    • Atlanta, Georgia, United States, 30338-6520
      • GA Psychiatric Services, LLC.
    • Buford, Georgia, United States, 30519
      • Buford Family Practice
    • Norcross, Georgia, United States, 30093
      • One Health Research Clinic, Inc.
    • Smyrna, Georgia, United States, 30082
      • Institute For Behavioral Medicine
  • Idaho
    • Meridian, Idaho, United States, 83642
      • Advanced Clinical Research Inc.
  • Illinois
    • Naperville, Illinois, United States, 60563
      • Conventions Psychiatry and Counseling
  • Indiana
    • Evansville, Indiana, United States, 47715
      • Pedia Research, LLC
  • Kansas
    • Overland Park, Kansas, United States, 66211
      • Psychiatric Associates
  • Kentucky
    • Bardstown, Kentucky, United States, 40004
      • Kentucky Pediatric/Adult Research
    • Owensboro, Kentucky, United States, 42301
      • Pedia Research, LLC
  • Maryland
    • Rockville, Maryland, United States, 20852
      • Neuroscientific Insights
  • Michigan
    • Bloomfield Hills, Michigan, United States, 48302
      • NeuroBehavioral Medicine Group
  • Missouri
    • Saint Charles, Missouri, United States, 63304
      • St Charles Psychiatric Associates
  • North Carolina
    • Durham, North Carolina, United States, 27707
      • Triangle Neuropsychiatry
  • Ohio
    • Dayton, Ohio, United States, 45414
      • Ohio Pediatric Research Association
    • Wadsworth, Ohio, United States, 44281
      • Family Practice Center of Wadsworth, Inc.
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73103
      • IPS Research Company
  • South Carolina
    • Charleston, South Carolina, United States, 29414
      • Coastal Pediatric Associates
    • Mount Pleasant, South Carolina, United States, 29464
      • Coastal Pediatric Associates
  • Tennessee
    • Nashville, Tennessee, United States, 37203
      • Access Clinical Trials, Inc.
  • Texas
    • El Campo, Texas, United States, 77437
      • El Campo Clinical Trials
    • Houston, Texas, United States, 77098
      • Houston Clinical Trials, LLC
    • League City, Texas, United States, 77573
      • Children's Clinic
    • San Antonio, Texas, United States, 78229-7822
      • University of Texas
  • Virginia
    • Charlottesville, Virginia, United States, 22903
      • University of Virginia Health System
    • Petersburg, Virginia, United States, 23805
      • VA South Psychiatric & Family Services
  • Washington
    • Bellevue, Washington, United States, 98007
      • Northwest Clinical Research Center
    • Richland, Washington, United States, 99352
      • Mid-Columbia Research

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 years to 12 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participant is male or female aged 6-12 years inclusive at the time of consent.
• Participant's parent or legally authorized representative (LAR) must provide signature of informed consent, and there must be documentation of assent (as applicable) by the participant.
• Participant must meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for a primary diagnosis of ADHD (any subtype).
• Participant who is a female and of child-bearing potential must not be pregnant and agree to comply with any applicable contraceptive requirements.
• Participant has an ADHD-RS-5 Child, Home Version Total Score of greater than or equal to (>=) 28 and Clinical Global Impression - Severity of Illness (CGI-S) score >=4 at baseline (Visit 2). Participant is currently not on ADHD therapy, or is not completely satisfied with their current ADHD therapy.

Exclusion Criteria:

• Participant is required or anticipated to take medications that have central nervous system effects or affect performance. Stable use of bronchodilator inhalers is not exclusionary.
• Participant has a concurrent chronic or acute illness, disability, or other condition that might confound the results of safety assessments conducted in the study or that might increase risk to the participant.
• Participant has a documented allergy, hypersensitivity, or intolerance to amphetamine or to any excipients in the investigational product.
• Participant has failed to fully respond, based on investigator judgment, to an adequate course of amphetamine therapy.
• Participant has a known family history of sudden cardiac death or ventricular arrhythmia.
• Participant has a blood pressure measurement >=95th percentile for age, sex, and height at screening (Visit 1) and/or baseline (Visit 2).
• Participant has a height less than or equal to (<=) 5th percentile for age and sex at screening (Visit 1) or baseline (Visit 2).
• Participant has a weight <=5th percentile for age and sex at screening (Visit 1) or baseline (Visit 2).
• Participant has a known history of symptomatic cardiovascular disease, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac conditions placing them at increased vulnerability to the sympathomimetic effects of a stimulant drug.
• Participant has a history of seizures (other than infantile febrile seizures).
• Participant is taking any medication that is excluded per the protocol.
• Participant had any clinically significant ECG or clinical laboratory abnormalities at the screening (Visit 1) or baseline visit (Visit 2).
• Participant has current abnormal thyroid function, defined as abnormal thyroid-stimulating hormone and thyroxine at the screening or baseline visit. Treatment with a stable dose of thyroid medication for at least 3 months is permitted.
• Participant has a current, controlled (requiring medication or therapy) or uncontrolled, comorbid psychiatric disorder.
• Participant is currently considered a suicide risk in the opinion of the investigator, has previously made a suicide attempt, or has a prior history of or currently demonstrating suicidal ideation.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SHP465; Participants will be randomized to receive SHP465 capsule 6.25 milligram (mg) orally once daily for 4 weeks.	Drug: SHP465; SHP465 capsule 6.25 mg orally once daily for 4 weeks
Placebo Comparator: Placebo; Participant will receive placebo matching to SHP465 capsule orally once daily for 4 weeks.	Drug: Placebo; Placebo matching to SHP465 capsule orally once daily for 4 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Attention-Deficit/Hyperactivity Disorder Rating Scale-5 (ADHD-RS-5) Total Score at Week 4	Clinician administered ADHD-RS-5, child, home version total score were analyzed. ADHD-RS-5 consisted of 18 items designed to reflect current symptomatology of ADHD based on diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria. Each item was scored on a 4-point scale ranging from 0 (reflecting no symptoms) to 3 (reflecting severe symptoms) with total scores ranging from 0-54. The 18 items were grouped into 2 subscales: hyperactivity or impulsivity (9 items) and inattentiveness (9 items). Higher total scores indicated higher impairment and lower scores indicated no impairment. Least square (LS) mean was calculated based on restricted maximum likelihood (REML) method of estimation and utilized an unstructured covariance type.	Baseline, Week 4

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Global Impression of Improvement (CGI-I) at Week 4	CGI scale was measured to rate the overall improvement of a participants condition on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). LS mean was calculated based on restricted maximum likelihood (REML) method of estimation and utilized an unstructured covariance type.	Week 4
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)	An adverse event (AE) was any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. TEAEs were defined as AEs that start or deteriorate on or after the date of the first dose of investigational product and no later than 3 days following the last dose of investigational product.	From start of study drug administration up to follow-up (Week 5)
Number of Participants With Clinically Significant Change in Vital Signs Were Reported as Adverse Event (AE)	Vital sign assessments included systolic and diastolic blood pressure and pulse. Participants with clinically significant deviations from baseline values which are deemed clinically significant in the opinion of the investigator were considered as AE's. An AE was any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment.	From start of study drug administration up to follow-up (Week 5)
Number of Participants With Clinically Significant Change in Clinical Laboratory Test Results Assessed by the Investigator	Clinical laboratory tests included biochemistry, endocrinology, hematology and urinalysis. The investigator assessed out-of-range clinical laboratory values for clinical significance, if the value(s) were not clinically significant or clinically significant.	From start of study drug administration up to follow-up (Week 5)
Number of Participants With Clinically Significant Change in Electrocardiogram (ECG) Assessed by the Investigator	Participants with clinically significant deviations from baseline values which are deemed clinically significant in the opinion of the investigator were considered in 12-lead ECG and reported.	From start of study drug administration up to follow-up (Week 5)
Number of Participants With Quality of Sleep Assessed by Post Sleep Questionnaire (PSQ) at Baseline and Week 4	The PSQ was a 7-item questionnaire typically used to assess sleep quality with pharmacologic treatment. The questionnaire collected data on average time to sleep, sleep latency, frequency of interrupted sleep, duration of interrupted sleep, total sleep time and sleep quality over the last week. Participants analyzed for number of times woke up per night category were only the participants who responded as yes for the woke up during the night category in this outcome measure.	Baseline, Week 4
Change From Baseline in Length of Time Awake Per Night and Length of Time to Fall Asleep Per Night Assessed by PSQ at Week 4	The PSQ was a 7-item questionnaire typically used to assess sleep quality with pharmacologic treatment. The questionnaire collected data on average time to sleep, sleep latency, frequency of interrupted sleep, duration of interrupted sleep, total sleep time and sleep quality over the last week.	Baseline, Week 4
Change From Baseline in Length of Time Sleeping Per Night Assessed by PSQ at Week 4	The PSQ was a 7-item questionnaire typically used to assess sleep quality with pharmacologic treatment. The questionnaire collected data on average time to sleep, sleep latency, frequency of interrupted sleep, duration of interrupted sleep, total sleep time and sleep quality over the last week.	Baseline, Week 4
Total Sleep Disturbance Score of Children's Sleep Habits Questionnaire (CSHQ ) at Week 4	The CSHQ is a validated, retrospective, parent-reported sleep screening tool. The questionnaire consists of 35 items that yield a TSD score, as well as 8 subscale scores, including bedtime resistance, sleep duration, parasomnias, sleep disordered breathing, night wakings, daytime sleepiness, sleep anxiety, and sleep onset delay. Parents were asked to think of a recent "typical" week of their child's sleep and to indicate how often sleep disturbance behaviors occurred. A 3-point scale was used for rating: "usually" if the sleep behavior occurs 5 to 7 times per week, "sometimes" for 2 to 4 times per week, and "rarely" for once or not at all during the week. The TSD score, which is the sum of all responses, included all items of the 8 subscales, but consisted of only 33 items because two on the bedtime resistance and sleep anxiety subscales were identical (range: 0, 99). A negative value indicates less sleep disturbance.	Week 4
Number of Participants With a Positive Response in Columbia-suicide Severity Rating Scale (C-SSRS) at Week 4	C-SSRS was a semi-structured interview that captures the occurrence, severity, and frequency of suicide-related thoughts and behaviors during the assessment period. The number of participants with clinical significant change in suicidal ideation and suicidal behavior were reported.	Week 4

Collaborators and Investigators

• Sponsor: Shire

Publications and helpful links

General Publications

• Mattingly G, Arnold V, Yan B, Yu M, Robertson B. A Phase 3, Randomized Double-Blind Study of the Efficacy and Safety of Low-Dose SHP465 Mixed Amphetamine Salts Extended-Release in Children with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol. 2020 Nov;30(9):549-557. doi: 10.1089/cap.2020.0005. Epub 2020 Oct 13.

Study record dates

Study Major Dates

• Study Start (Actual): December 9, 2017
• Primary Completion (Actual): June 7, 2018
• Study Completion (Actual): June 7, 2018

Study Registration Dates

• First Submitted: October 26, 2017
• First Submitted That Met QC Criteria: October 26, 2017
• First Posted (Actual): October 30, 2017

Study Record Updates

• Last Update Posted (Actual): June 2, 2021
• Last Update Submitted That Met QC Criteria: May 13, 2021
• Last Verified: May 1, 2021

More Information

Terms related to this study

• Keywords: ADHD; Hyperactivity; SHP465
• Additional Relevant MeSH Terms: Mental Disorders; Nervous System Diseases; Neurologic Manifestations; Dyskinesias; Attention Deficit and Disruptive Behavior Disorders; Neurodevelopmental Disorders; Attention Deficit Disorder with Hyperactivity; Hyperkinesis
• Other Study ID Numbers: SHP465-309

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement.
• IPD Sharing Access Criteria: IPD from eligible studies will be shared with qualified researchers according to the criteria and process described on https://vivli.org/ourmember/takeda/. For approved requests, the researchers will be provided access to anonymized data (to respect patient privacy in line with applicable laws and regulations) and with information necessary to address the research objectives under the terms of a data sharing agreement.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No