- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07564245
Efficacy of Cannabidiol in the Management of Self-injuries in Children and Adolescents With Severe Neurodevelopmental Disorders. (CBD-SIB)
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
The objective of this project is to study the effect of cannabidiol in children with severe neurodevelopmental disorders who engage in significant self-injury, both on the frequency and severity of self-injury and on nonverbal expressions of pain. We expect a positive effect on both of these parameters, as well as a correlation between a reduction in nonverbal expressions of pain and a reduction in the frequency and severity of self-injury. If our expectations are confirmed, this would contribute to expanding the use of cannabidiol, verifying its tolerability in this patient population, and understanding the factors associated with a positive response to this unconventional treatment in order to clarify its indications.
The experimental treatment is the same for all participants. It consists of a cannabidiol (CBD) solution for oral administration: EPIDYOLEX® will be administered orally in two equal doses per day, 12 hours apart, preferably with breakfast and dinner.
Type d'étude
Inscription (Estimé)
Phase
- Phase 2
Contacts et emplacements
Coordonnées de l'étude
- Nom: Laure CHOUPEAUX, Msc
- Numéro de téléphone: +33 01 44 38 17 11
- E-mail: laure.choupeaux@aphp.fr
Sauvegarde des contacts de l'étude
- Nom: Pauline CHASTE, MD; PhD
- Numéro de téléphone: 01 44 49 57 59
- E-mail: pauline.chaste@aphp.fr
Lieux d'étude
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Île-de-France Region
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Paris, Île-de-France Region, France, 75015
- Hôpital Necker Enfants malades
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Contact:
- Pauline CHASTE
- E-mail: pauline.chaste@aphp.fr
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Paris, Île-de-France Region, France, 75013
- Hôpital Pitié-Salpêtrière
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Contact:
- David COHEN, MD, PHD
- E-mail: david.cohen@aphp.fr
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
Accepte les volontaires sains
La description
Inclusion Criteria:
- Age between 5 years and 17 years 6 months;
- Weight between 12 and 49.9 kg;
- Clinical diagnosis of severe neurodevelopmental disorder including severe to profound intellectual developmental disorder, characterized in the DSM-5 by a need for help with any daily activity (meals, dressing, toileting, elimination) and the need for constant supervision;
Severe self-injuries during the last 7 days defined by BPI-01, i.e.:
- at least one type of self-injuries assessed as severe intensity occurring at least once every 3 hours while awake or
- at least two types of self-injuries assessed as severe intensity occurring at least once every 6 hours each while awake;
- Self-injuries refractory to treatment with atypical neuroleptic (RISPERIDONE, ARIPIPRAZOLE, etc.) at a dosage deemed effective by the investigator in view of the patient's weight, age and background, for a minimum duration of 30 days (except in the case of poor tolerance by the patient);
- No change in drug and non-drug treatments such as rehabilitative care (psychomotricity, occupational therapy, speech therapy, intervention by a specialist educator) for at least one month;
- In WOCBP and with active sexual life: negatives hCG and use of highly effective contraceptive measure until 18 days after the end of the treatment.
- The participant has a caregiver who can reliably accompany him/her to all clinic visits, provide reliable assessments, help him/her to comply with study requirements, and interact with him/her on a regular basis.
- Signature of Consent of both holders of parental authority;
- Affiliation to social security regimen.
Exclusion Criteria:
- 1. Underweight corresponding to a body mass index below the IOTF 18.5 curve on the International Obesity Task Force's body mass index curves for girls and boys 2. Hypersensitivity to the active substance (cannabidiol) or to any of the excipients (refined sesame oil, anhydrous ethanol, sucralose, strawberry flavor, benzyl alcohol); 3. Treatment with or consumption of cannabidiol in the 12 weeks prior to inclusion; 4. Consumption of cannabis in the 12 weeks prior to inclusion; 5. Usual treatment (excluding treatment of self-injuries) containing molecules interacting with cannabidiol (rifampicin, carbamazepine, enzalutamide, mitotane, St. John's wort, clobazam, valproate, stiripentol, phenytoin, lamotrigine, everolimus, theophylline, tizanidine, bupropion, efavirenz, diflunisal, propofol, fenofibrate, gemfibrozil, morphine, lorazepam, repaglinide, warfarin, sirolimus, tacrolimus, digoxin); 6. Elevated transaminases > 3N or total bilirubin > 2N; 7. Known current heart failure; 8. Known current terminal renal failure (GFR < 15 ml/min/1.73 m2); 9. Known current moderate or severe hepatic insufficiency (Child-Pugh B or C); 10. Known current epilepsy or history of epilepsy, even stabilized, requiring treatment currently or not, whatever the type; 11. Pregnancy or breastfeeding; 12. Inability of the patient or entourage to comply with the study protocol; 13. Patient currently participating in another interventional research (category 1 or 2), clinical trial or clinical investigation, or who are in the exclusion period following him/her participation in another study of this type, as defined in the protocol of that study.
14. Participant related to a person involved in the study at the investigational site
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Cannabidiol
Multicentre phase II study evaluating the efficacy of CANNABIDIOL (EPIDYOLEX®) in reducing self-injuries and non-verbal expressions of pain in children and adolescents with severe neurodevelopmental disorders.
The experimental treatment is the same for all participants will last 63 days.
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EPIDYOLEX® will be administered orally in two equivalent doses taken 12 hours apart each day.
It will be started at a dose of 5 mg/kg/day and gradually increased to 25 mg/kg/day over a titration period of 28 days.
The target dose of 25 mg/kg/day will be maintained for 35 days.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Efficacy of cannabidiol
Délai: Day 63
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Efficacy is evaluate by reducing the frequency of self-injuries.
Cannabidiol will be considered effective at V8 Day 63 in clinically significant reductions in the frequency of self-injuries if the frequency score on the 'Self-injurious behaviour subdomain of the BPI-01 is reduced by 30% or more at the V8 Day 63 visit compared to the V2 Day 0 visit.
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Day 63
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Efficacy of cannabidiol
Délai: Day 29
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Cannabidiol will be considered effective at Visit6 Day29 in clinically significant reduction in the frequency of self-injuries if the frequency score in the 'Self-injurious behaviour' sub-domain of the BPI-01 is reduced by 30% or more at the Visit6 Day29 visit compared with the Visit2 Day 0 visit.
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Day 29
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Efficacy of cannabidiol / severity of self-injuries
Délai: Day 29
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the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V6 Day29. For this criteria: severity score in the 'Self-injurious behaviour' sub-domain of BPI-01 |
Day 29
|
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Efficacy of cannabidiol / severity of self-injuries
Délai: Day 63
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63. For this criteria: severity score in the 'Self-injurious behaviour' sub-domain of BPI-01 |
Day 63
|
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Efficacy of cannabidiol / severity of Stereotyped behaviour
Délai: Day 29
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The efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day0 and visits V6 Day29. For this criteria: severity score for the BPI-01 sub-domain 'Stereotyped behaviour |
Day 29
|
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Efficacy of cannabidiol / severity of Stereotyped behaviour
Délai: Day 63
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63. For this criteria: severity score for the BPI-01 sub-domain 'Stereotyped behaviour |
Day 63
|
|
Efficacy of cannabidiol / frequency of Stereotyped behaviour
Délai: Day 29
|
The efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V6 Day 29. For this criteria: frequency score for the BPI-01 sub-domain 'Stereotyped behaviour |
Day 29
|
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Efficacy of cannabidiol / frequency of Stereotyped behaviour
Délai: Day 63
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63. For this criteria: frequency score for the BPI-01 sub-domain 'Stereotyped behaviour |
Day 63
|
|
Efficacy of cannabidiol / severity of Aggressive/destructive behaviour
Délai: Day 29
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V6 Day 29. For this criteria: severity score for the BPI-01 sub-domain 'Aggressive/destructive behaviour' |
Day 29
|
|
Efficacy of cannabidiol / severity of Aggressive/destructive behaviour
Délai: Day 63
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63. For this criteria: severity score for the BPI-01 sub-domain 'Aggressive/destructive behaviour' |
Day 63
|
|
Efficacy of cannabidiol / frequency of Aggressive/destructive behaviour
Délai: Day 29
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V6 Day 29. For this criteria: frequency score for the BPI-01 sub-domain 'Aggressive/destructive behaviour' |
Day 29
|
|
Efficacy of cannabidiol / frequency of Aggressive/destructive behaviour
Délai: Day 63
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63. For this criteria: frequency score for the BPI-01 sub-domain 'Aggressive/destructive behaviour' |
Day 63
|
|
Efficacy of cannabidiol / the frequency of non-verbal expressions of pain
Délai: Day 29
|
the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V6 Day 29 in GED-DI score
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Day 29
|
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Efficacy of cannabidiol / the frequency of non-verbal expressions of pain
Délai: Day 63
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the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63 in GED-DI score
|
Day 63
|
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Efficacy of cannabidiol / quality of life
Délai: Day 29
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the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V6 Day 29 in QI-Disability score
|
Day 29
|
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Efficacy of cannabidiol / quality of life
Délai: Day 63
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the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63 in QI-Disability score
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Day 63
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Efficacy of cannabidiol / stress related to the child experienced by the parents.
Délai: Day 29
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the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V6 Day 29 in Parental Stress Scale (PSS) score
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Day 29
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Efficacy of cannabidiol / stress related to the child experienced by the parents.
Délai: Day 63
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the efficacy of the treatment will be assessed by the percentage change in percentage scores between visit V2 Day 0 and visits V8 Day 63 in Parental Stress Scale (PSS) score
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Day 63
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Safety of EPIDYOLEX®
Délai: Day 81
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serious and non-serious clinical and biological adverse events
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Day 81
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Correlation between the evolution of the frequency of self-injuries and the evolution of the frequency of non-verbal expressions of pain
Délai: Day 29
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Correlation between the evolution of the frequency of self-injuries (frequency score in the BPI-01 subdomain 'Self-injurious behaviour') and the evolution of the frequency of non-verbal expressions of pain (GED-DI score)
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Day 29
|
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Correlation between the evolution of the frequency of self-injuries and the evolution of the frequency of non-verbal expressions of pain
Délai: Day 63
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Correlation between the evolution of the frequency of self-injuries (frequency score in the BPI-01 subdomain 'Self-injurious behaviour') and the evolution of the frequency of non-verbal expressions of pain (GED-DI score)
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Day 63
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Pauline CHASTE, MD; PhD, Assistance Publique - Hôpitaux de Paris
- Directeur d'études: Maryse PAGNIER, MD; PhD, Assistance Publique - Hôpitaux de Paris
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
- Évaluation de la douleur
- Stress parental
- Troubles neurodéveloppementaux
- Épidyolex
- Cannabidiol, self-injuries
- Vineland Adaptive Behaviour II
- Behavior Problems Inventory - 01 (BPI-01)
- Pain Evaluation- Intellectual Disability (GED-DI)
- Quality of life inventory - Disability (QI-Disability)
- Parental Stress Scale (PSS)
- Non Communicating Children's Pain
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- APHP240090
- 2025-521161-27-00 (Ctis)
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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