- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT03848481
CBDV versus placebo bij kinderen en volwassenen tot 30 jaar met Prader-Willi-syndroom (PWS)
Cannabidivarine (CBDV) vs. Placebo bij kinderen en volwassenen tot 30 jaar met het Prader-Willi-syndroom (PWS)
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
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New York
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The Bronx, New York, Verenigde Staten, 10467
- Montefiore Medical Center, Albert Einstein College of Medicine
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Beschrijving
Inclusiecriteria
- Mannelijke of vrouwelijke poliklinische patiënten van 5 tot 30 jaar.
- Diagnose van PWS bevestigd door genetische tests en medische dossiers en geschiedenis van de patiënt.
- Stabiele farmacologische, educatieve, gedrags- en/of dieetinterventies gedurende 4 weken voorafgaand aan de start van de studie en voor de duur van de studie.
- Zorg voor een lichamelijk onderzoek en laboratoriumresultaten die binnen de normen voor PWS vallen
- Aanwezigheid van een ouder/verzorger/voogd die toestemming kan geven voor hun deelname en volledige beoordelingen met betrekking tot de ontwikkeling en het gedrag van de patiënt gedurende het onderzoek. Instemming van kinderen wordt verkregen als de proefpersoon 7 jaar of ouder is en de mentale capaciteit heeft om een schriftelijk toestemmingsformulier te begrijpen en te ondertekenen en/of mondelinge toestemming te geven.
- Score op de Clinical Global Impression Scale Severity (CGI-S) ≥ 4 (matige ernst) bij baseline.
- Score van ≥18 op de Aberrant Behavior Checklist-Irritability (ABC-I) bij baseline.
- Ga akkoord om niet te rijden of machines te bedienen.
Uitsluitingscriteria
- Blootstelling aan een onderzoeksmiddel in de 30 dagen voorafgaand aan randomisatie.
- Eerdere chronische behandeling met CBD of CBDV.
- Positief getest op THC of andere misbruikende drugs via urinetesten tijdens het screeningsbezoek of basisbezoeken bij herhaalde bevestigingstesten.
- Geschiedenis van drugsmisbruik, inclusief stoornis in het gebruik van cannabis
- Een andere primaire psychiatrische diagnose dan PWS, waaronder bipolaire stoornis, psychose, schizofrenie, PTSS of MDD. Deze patiënten zullen worden uitgesloten vanwege mogelijk verwarrende resultaten.
- Een medische aandoening die het vermogen van de proefpersoon om deel te nemen aan het onderzoek ernstig beïnvloedt, de uitvoering van het onderzoek verstoort, de interpretatie van onderzoeksresultaten vertroebelt of het welzijn van de proefpersoon in gevaar brengt (inclusief maar niet beperkt tot lever- of nierfunctiestoornissen en hart- en vaatziekten).
- Bekende of vermoede allergie voor CBDV of hulpstoffen die in de formulering worden gebruikt (d.w.z. sesam).
- Klinische indicaties van nier-, pancreas- of hematologische disfunctie zoals blijkt uit waarden boven de bovengrens van normaal voor BUN/creatinine, waarden tweemaal de bovengrens van normaal voor serumlipase en amylase, bloedplaatjes
- ECG-afwijking bij baselinescreening of klinisch significante houdingsdaling van de systolische bloeddruk bij screening. Als het eerste screenings-ECG een QTcB van meer dan 460 msec laat zien, worden er 2 extra ECG's gemaakt in dezelfde zitting, met een tussenpoos van 5 minuten. Indien niet herkend bij screening, dan een volledige herhaling in drievoud met een gemiddelde QTcB van 460 msec of minder om aan alle opname-/uitsluitingscriteria te voldoen
- Vrouwelijke proefpersonen die zwanger zijn, zullen van het onderzoek worden uitgesloten. Als een vrouwelijke proefpersoon zwanger kan worden, krijgt ze een zwangerschapstest voordat ze aan het onderzoek begint. Vrouwelijke proefpersonen zullen worden geïnformeerd dat ze niet zwanger kunnen worden tijdens het gebruik van CBDV. Vrouwelijke proefpersonen moeten het de onderzoeker vertellen en een verloskundige of moeder-foetale specialist raadplegen als ze tijdens het onderzoek zwanger worden.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Cannabidivarine (CBDV)
Op gewicht gebaseerde dosering van 10 mg/kg/dag CBDV gedurende 12 weken
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CBDV is obtained from the Cannabis sativa L. plant and contains a negligible quantity (less than 0.2%) of Tetrahydrocannabinol (THC).
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Placebo-vergelijker: Overeenkomende Placebo
Op gewicht gebaseerde dosering van 10 mg/kg/dag placebo gedurende 12 weken
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Placebo drank bevat bijpassende hulpstoffen.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Irritability Based on Aberrant Behavior Checklist-Irritability (ABC-I) Subscale
Tijdsspanne: Baseline, Week 4, Week 8, Week 12
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Irritability will be assessed using the Aberrant Behavior Checklist-Irritability Subscale (ABC-I).
The ABC-I is a well-characterized outcome that is accepted by the FDA for the purpose of labeling and is one of the best and most validated outcome measures in the developmental disabilities.
The ABC-Irritability subscale consists of 15 questions that address the presence of irritability, aggression, tantrums and/or self-injury.
Each item is rated on a scale ranging from 0 ("Not at all a problem") to 3 ("Severe problem"), resulting in a total score range of 0-45, such that higher ABC-I scores are indicative of more severe behavioral problems.
Subjects must score an 18 or higher at screening to be included in the study.
ABC-I scores for Week 4, Week 8, and Week 12 are summarized in the table by study arm using descriptive statistics.
Baseline results for this outcome can be found in the Baseline Characteristics module.
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Baseline, Week 4, Week 8, Week 12
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Repetitive Behavior Based on the Repetitive Behavior Scale-Revised (RBS-R).
Tijdsspanne: Baseline, Week 4, Week 8, Week 12
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Repetitive behavior will be evaluated using the RBS-R.
RBS-R is a 43-item self-report questionnaire used to measure the breadth or repetitive behaviors in children, adolescents, and adults with ASD.
The RBS-R consists of 6 subscales: Stereotyped Behavior, Self-injurious Behavior, Compulsive Behavior, Ritualistic Behavior, Sameness Behavior, and Restricted Behavior that have no overlap of item content.
Each of the 43 items are rated on a 4-point Likert scale ranging from 0 ("Behavior does not occur") to 3 ("Behavior occurs and is a severe problem"), yielding an overall scoring range of 0-129, such that higher scores are associated with increased severity of the problem behavior.
RBS-R scores for Week 4, Week 8, and Week 12 are summarized in the table by study arm using descriptive statistics.
Baseline results for this outcome can be found in the Baseline Characteristics module.
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Baseline, Week 4, Week 8, Week 12
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Repetitive Behaviors Based on Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)
Tijdsspanne: Baseline, Week 4, Week 8, Week 12
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Obsessive-compulsive symptoms will be assessed using the CY-BOCS.
The CY-BOCS is 10-item clinician-rated measure designed to assess the severity of obsessive-compulsive symptoms in children/adolescents over the prior week.
It consists of 5 primary sections: Time, Distress, Interference, Resistance, and Control of Symptoms.
The 10 items are rated on a scale from 0 ("No symptoms") to 4 ("Extreme symptoms"), for an overall possible range of 0-40, with higher scores indicative of greater severity of symptoms.
CY-BOCS scores for Week 4, Week 8, and Week 12 are summarized by study arm using descriptive statistics.
Baseline results for this outcome can be found in the Baseline Characteristics module.
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Baseline, Week 4, Week 8, Week 12
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Hyperphagia
Tijdsspanne: Baseline, Week 4, Week 8, Week 12
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Hyperphagia will be assessed using the Hyperphagia Questionnaire for Clinical Trials (HQ-CT).
The HQ-CT is a 9-item caregiver-reported measure of the frequency and intensity of food-seeking behaviors in participants with Prader-Willi Syndrome (PWS) over the prior two-week period.
The 9 items are graded on a Likert scale ranging from 0 ("No Hyperphagia") to 4 ("Most severe hyperphagia"), yielding an overall possible scoring range of 0-36, with higher scores indicating greater, more severe hyperphagia.
HQ-CT scores for Week 4, Week 8, and Week 12 are summarized by study arm using descriptive statistics.
Baseline results for this outcome can be found in the Baseline Characteristics module.
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Baseline, Week 4, Week 8, Week 12
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Global Functioning
Tijdsspanne: Week 4, Week 8, Week 12
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Global Functioning will be assessed using the Clinical Global Impression Scale - Improvement (CGI-I).
The CGI-I is a global assessment which measures the change in a participant's illness severity, relative to a baseline, considering all symptoms, behaviors, and functional impairment.
It consists of a 7-point clinician-rated scale as follows: 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, 7 = very much worse.
such that higher scores are indicative of worsening global function.
CGI-I scores for Week 4, Week 8, and Week 12 are summarized by study arm using basic descriptive statistics.
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Week 4, Week 8, Week 12
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Caregiver Strain
Tijdsspanne: Baseline, Week 4, Week 8, Week 12
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Caregiver Strain will be evaluated using the Caregiver Strain Questionnaire (CSQ).
The CSQ is a 21-item self-report questionnaire, consisting of 3 subscales, developed to assess caregiver strain/stress for families with a child living with an emotional or behavioral disorder.
Items 1-11 assess Objective Strain.
Items 12, 16-18, and 20-21 assess Subjective Internalized Strain.
Items 13-15, and 19 assess Subjective Externalize Strain.
All CSQ items are rated from 1 ("Not at all a problem") to 5 ("Very much a problem").
Scores are calculated by averaging items within each subscale to handle missing data and calculating a Global Score by summing the 3 subscale means for a total possible scale range of 3-15.
Higher Global Scores are associated with increased Caregiver Strain.
Global results scores for Week 4, Week 8, and Week 12 are summarized by study arm using descriptive statistics.
Baseline results for this outcome can be found in the Baseline Characteristics module.
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Baseline, Week 4, Week 8, Week 12
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Rigid Behavior - Based on the Montefiore-Einstein Rigidity Scale-Revised-Prader-Willi Syndrome Scale (MERS-R-PWS)
Tijdsspanne: Week 12
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Rigid behavior will be assessed based using the MERS-R-PWS. The MERS-R-PWS is a clinician-rated scale designed to assess 3 domains of rigid behavior in individuals with PWS: Behavioral Rigidity (e.g., Insistence on sameness, things must be done in his/her way, etc.) Cognitive Rigidity (e.g., Special interests, inflexible adherence to rules, etc.) Protest (in response to deviation from rigidity; e.g., tantrum, irritability, arguing) Each domain consists of 4 items rated on a 5-point scale ranging from 0 ("No/None/Not difficult") to 4 ("Extreme/Extremely Difficult"), yielding a range of 0-16. Scores at Week 12 will only be completed for subjects who display rigid behaviors at baseline, week 4, week 8 and week 12. A total MERS-R-PWS score (0-48) is obtained by summing subscale score. Individual subscale scores (0-16) are also summarized. Higher MERS-R-PWS scores are indicative of greater rigidity within each domain and overall rigidity. |
Week 12
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Aberrant Behavior
Tijdsspanne: Baseline, Week 4, Week 8, Week 12
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Aberrant Behavior will be assessed using the Aberrant Behavior Checklist (ABC).
The ABC is a 58-item informative rating instrument used to measure maladaptive behaviors in individuals with developmental disabilities and ASD which resolves into 5 subscales: Irritability (15 items); Lethargy/Social withdrawal (16 items); Stereotypic behavior (7 items); Hyperactivity/noncompliance (16 items); and Inappropriate speech (4 items).
The ABC is completed by a parent/caregiver who knows the participant well.
The ABC measures behavior on a 4-point Likert severity scale: (0 = "Not all a problem," 1 = "Slight problem," 2 = "Moderately serious problem," and 3 = "Severe problem").
Scores for 4 of the 5 subscales are reported below (ABC-I results reported as part of the primary outcome).
Higher ABC subscale scores indicate greater behavioral severity/dysfunction of that subscale.
Week 4, Week 8, and Week 12 scores are summarized by study arm.
See Baseline Characteristics module for baseline data.
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Baseline, Week 4, Week 8, Week 12
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Sleep Quality
Tijdsspanne: Baseline through Week 12
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Sleep quality will be assessed using ActiGraph GT9X-BT® activity monitors.
Successfully screened patients will receive the actigraphy device prior to the onsite baseline visit and will record a minimum of three days of baseline activity data prior to study initiation.
The ActiGraph GT9X-BT activity monitors are a well validated activity and sleep monitoring device widely utilized in clinical trials and health research.
For this study the ActiGraph monitors will measure: Sleep Latency (the time it takes to fall asleep), Total Sleep Time (the total amount of time spent asleep), and sleep efficiency (percentage of time in bed actually spent sleeping).
Sleep data is captured automatically via cloud service.
All parameters will be reported in hours/minutes and summarized by study arm.
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Baseline through Week 12
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Eric Hollander, MD, Montefiore Medical Center/Albert Einstein College of Medicine
Publicaties en nuttige links
Algemene publicaties
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- Irizarry KA, Miller M, Freemark M, Haqq AM. Prader Willi Syndrome: Genetics, Metabolomics, Hormonal Function, and New Approaches to Therapy. Adv Pediatr. 2016;63(1):47-77.
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- Knuesel I, Chicha L, Britschgi M, et al. Maternal immune activation and abnormal brain development across CNS disorders. Nat Rev Neurol. 2014;10(11):643-660.
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- McCandless SE, Yanovski JA, Miller J, et al. Effects of MetAP2 inhibition on hyperphagia and body weight in Prader-Willi syndrome: A randomized, double-blind, placebocontrolled trial. Diabetes Obes Metab. 2017;19(12):1751-1761.
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Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Inprentingsstoornissen
- Neurologische manifestaties
- Ziekten van het zenuwstelsel
- Voedingsstoornissen
- Genetische ziekten, aangeboren
- Overvoeding
- Neurologische gedragsmanifestaties
- Aangeboren afwijkingen
- Afwijkingen, meerdere
- Overgewicht
- Verstandelijk gehandicapt
- Obesitas
- Chromosoomaandoeningen
- Aangeboren, erfelijke en neonatale ziekten en afwijkingen
- Voedings- en stofwisselingsziekten
- Prader-Willi-syndroom
- cannabidivarine
Andere studie-ID-nummers
- 2019-9914
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
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IPD-toegangscriteria voor delen
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
- ICF
- MVO
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