Folinic Acid as a Treatment for Autism Spectrum Disorder in Children (FOLIN-A)
Folinic Acid as a Treatment for Autism Spectrum Disorder in Children: A Double-blind Randomised Placebo-controlled Trial With Open Label Extension (FOLIN-A Trial)
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Fáze 2
Kontakty a umístění
Studijní kontakt
Studijní kontakt
- Jméno: Study Coordinator
- Telefonní číslo: 6563947201
- E-mail: folin-a@kkh.com.sg
Studijní místa
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Singapore
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Singapore, Singapore, Singapur
- Nábor
- KK Women's and Children's Hospital
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dítě
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Children aged 3 years 0 months to 10 years 11 months at the time of enrolment
- Weight ≥ 10 kg and ≤ 30 kg at the time of enrolment
- Confirmed diagnosis of Autism Spectrum Disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) or Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, supported by standardized diagnostic assessments
- Stable on regular behavioral interventions and any medications for at least 6 months prior to enrolment
- At least one parent or legal guardian able to understand and complete study questionnaires in English
- Written informed consent obtained from a parent or legal guardian
Exclusion Criteria:
- Known allergy or intolerance to folinic acid
- Current or prior supplementation with folinic acid or other folate preparations (folic acid supplementation permitted)
- Vitamin B12 (cobalamin) deficiency or pernicious anemia
- Concurrent use of medications known to interfere with folate metabolism (e.g., methotrexate, trimethoprim, fluorouracil, capecitabine, glucarpidase)
- Known genetic, metabolic, or chromosomal disorder, or structural brain abnormalities
- History of epilepsy or seizures (except simple febrile seizures) or current use of antiepileptic or antipsychotic medication
- Significant sensory (hearing or visual) or motor impairment
- Participation in another interventional clinical trial for autism within the past 6 months
- Unable or unwilling to comply with study visits and procedures
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Čtyřnásobek
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
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Experimentální: Folinic Acid
Participants in this arm will receive folinic acid during the double-blind randomised controlled trial (RCT) phase of the study.
After completion of the double-blind phase, participants will continue into an open-label extension in which folinic acid is provided.
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Oral folinic acid administered during the double-blind randomised controlled trial (RCT) phase, followed by open-label folinic acid treatment.
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Komparátor placeba: Placebo
Participants in this arm will receive a matching placebo during the double-blind randomised controlled trial (RCT) phase of the study.
After completion of the double-blind phase, participants will continue into an open-label extension in which folinic acid is provided.
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Matching oral placebo administered during the double-blind randomised controlled trial (RCT) phase.
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Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Change in Pervasive Developmental Disorder-Behavior Inventory (PDDBI) Autism Composite T-Score
Časové okno: Baseline to Week 12
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The Pervasive Developmental Disorder-Behavior Inventory (PDDBI) is a validated caregiver-completed instrument used to assess adaptive and maladaptive behaviors in individuals with autism spectrum disorder (ASD).
The Autism Composite T-score is a standardized score (mean = 50, standard deviation = 10) that summarizes overall autism symptom severity, with higher scores indicating greater symptom severity.
This outcome measure evaluates the change from baseline to Week 12 in PDDBI Autism Composite T-score.
Lower T-scores indicate improvement in autism-related symptoms.
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Change from baseline in language function as measured by the Clinical Evaluation of Language Fundamentals (CELF)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in standardized language function scores as assessed using the Clinical Evaluation of Language Fundamentals (CELF), a standardized individually administered assessment of receptive and expressive language skills in children.
CELF standardized scores have a mean of 100 and a standard deviation of 15, with higher scores indicating better language performance.
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Change from baseline in receptive vocabulary score as measured by the Receptive One-Word Picture Vocabulary Test (ROWPVT)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in standardized receptive vocabulary scores as assessed using the Receptive One-Word Picture Vocabulary Test (ROWPVT), a standardized individually administered assessment of a child's ability to understand spoken words.
Scores are standardized with a mean of 100 and a standard deviation of 15, where higher scores indicate better receptive vocabulary ability.
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Change from baseline in expressive vocabulary score as measured by the Expressive One-Word Picture Vocabulary Test (EOWPVT)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in standardized expressive vocabulary scores as assessed using the Expressive One-Word Picture Vocabulary Test (EOWPVT), a standardized individually administered assessment of a child's ability to produce spoken words.
Scores are standardized with a mean of 100 and a standard deviation of 15, where higher scores indicate better expressive vocabulary ability.
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Change from baseline in Clinical Global Impression-Severity and Improvement scores as measured by the Clinical Global Impression Scale (CGI-S and CGI-I)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in Clinical Global Impression-Severity (CGI-S) and Clinical Global Impression-Improvement (CGI-I) scores, assessed using the Clinical Global Impression Scale, a standardized assessor-rated measure of illness severity and overall clinical improvement.
CGI-S scores range from 1 (normal, not at all ill) to 7 (among the most extremely ill), where lower scores indicate better outcomes, and CGI-I scores range from 1 (very much improved) to 7 (very much worse), where lower scores indicate greater improvement.
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Change from baseline in Aberrant Behavior Checklist total score as measured by the Aberrant Behavior Checklist (ABC)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in total scores on the Aberrant Behavior Checklist (ABC), a standardized caregiver-completed questionnaire that assesses behavioural symptoms in children across domains such as irritability, lethargy, stereotypy, hyperactivity, and inappropriate speech.
Total scores range from 0 to 174, with higher scores indicating greater severity of behavioural problems (worse outcomes).
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Change from baseline in total problem score as measured by the Child Behavior Checklist (CBCL)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in total problem scores on the Child Behavior Checklist (CBCL), a standardized caregiver-reported questionnaire that assesses a broad range of emotional and behavioural problems in children.
Total scores are standardised T-scores (typically ranging from approximately 30 to 100, with a mean of 50 and standard deviation of 10), where higher scores indicate greater behavioural and emotional problems (worse outcomes).
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Change from baseline in adaptive behavior composite score as measured by the Vineland Adaptive Behavior Scales (VABS)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in standardised adaptive behavior scores as assessed using the Vineland Adaptive Behavior Scales (VABS), a standardized caregiver-reported assessment of a child's adaptive functioning across domains such as communication, daily living skills, socialization, and motor skills.
Adaptive behavior composite scores are standardised (typically ranging from approximately 20 to 160, with a mean of 100 and standard deviation of 15), where higher scores indicate better adaptive functioning (better outcomes).
Changes in scores will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Change from baseline in proportion of gaze duration to social stimuli as measured by eye-tracking assessment
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in eye-tracking measures of visual attention, specifically the proportion of total gaze duration directed toward social stimuli (e.g., faces or biological motion) compared with non-social stimuli, assessed using a standardized eye-tracking paradigm.
Higher proportions indicate greater relative attention to social stimuli.
Changes in proportions will be compared between participants receiving folinic acid and those receiving placebo.
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Baseline to Week 12
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Incidence of adverse events and serious adverse events as measures of safety and tolerability of folinic acid
Časové okno: Baseline to Week 24
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Change from baseline to Week 24 in the incidence of adverse events (AEs) and serious adverse events (SAEs), monitored throughout the study period to assess the safety and tolerability of folinic acid treatment.
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Baseline to Week 24
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Další výstupní opatření
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Change from baseline in plasma glutathione redox ratio (GSH:GSSG)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in plasma glutathione redox ratio (reduced glutathione:oxidized glutathione; GSH:GSSG), a biomarker of oxidative stress balance.
Higher ratios indicate a more reduced (favorable) redox state.
Plasma reduced glutathione (GSH, µM) and oxidized glutathione (GSSG, µM) will be measured at baseline (T1) and Week 12 (T2).
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Baseline to Week 12
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Change from baseline in plasma methylation ratio (S-adenosylmethionine:S-adenosylhomocysteine; SAM:SAH)
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in plasma methylation ratio (S-adenosylmethionine:S-adenosylhomocysteine; SAM:SAH), a biomarker of methylation capacity.
Higher ratios indicate greater methylation potential (better outcomes).
Additional biomarkers related to one-carbon metabolism, including plasma homocysteine (µmol/L), will measured where available.
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Baseline to Week 12
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Change in Plasma Ergothioneine Levels
Časové okno: Baseline to Week 12
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Change from baseline to Week 12 in plasma ergothioneine concentration (ET, nM).
Plasma ergothioneine (ET, nM), hercynine (nM), and ophthalmic acid will be measured at baseline (T1) and Week 12 (T2).
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Baseline to Week 12
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Change in Folate Status Biomarkers
Časové okno: Baseline to Week 12
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Change from baseline in serum and plasma folate status biomarkers.
Folate status biomarkers include measures related to one-carbon metabolism and amino acid pathways.
Plasma amino acid concentrations (µmol/L) will be interpreted with reference to established age-specific clinical ranges.
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Baseline to Week 12
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Association of FRAA Status With Treatment Response
Časové okno: Baseline to Week 12
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Association between folate receptor autoantibody (FRAA) status and change in autism outcome measures.
FRAA status will be classified as positive or negative based on the assay-specific cutoff defined by the testing laboratory: Blocking FRAA (pmol blocked per mL) and binding FRAA (optical density [OD] units per µL).
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Baseline to Week 12
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Sustained Effects of Folinic Acid on Autism Symptoms
Časové okno: Baseline to Week 24
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Change from baseline in autism outcome measures following 24 weeks of folinic acid treatment.
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Baseline to Week 24
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Duševní poruchy
- Neurologické vývojové poruchy
- Poruchy vývoje dítěte, všudypřítomné
- Poruchou autistického spektra
- Heterocyklické sloučeniny
- Heterocyklické sloučeniny, 2-prsten
- Heterocyklické sloučeniny, fúzované kroužek
- Enzymy a koenzymy
- Formyltetrahydrofoláty
- Tetrahydrofoláty
- Kyselina listová
- Pteriny
- Pteridiny
- Koenzymy
- Leukovorin
Další identifikační čísla studie
Další identifikační čísla studie
- FOLIN-A-01
- MOH-CIRG24jan-0004 (Jiné číslo grantu/financování: National Medical Research Council (NMRC), Singapore)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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