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The purpose of this study is to evaluate the safety and tolerability of memantine in pediatric (6-12 years old) patients with autism, Asperger's Disorder, or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and to identify responders for participation in a follow-up randomized withdrawal study.
This 50-week multicenter and multinational clinical study is comprised of a 2-week screening period, a 6-week open-label dose-titration period followed by a variable duration maintenance period (up to 42 weeks).
Patients with at least 12 weeks of investigational product exposure who meet the protocol specified responder criterion at two consecutive visits separated by at least two weeks are eligible to transition to a randomized withdrawal study. A responder is defined as a patient who demonstrates at least a 10 point improvement (reduction in score) in the Social Responsiveness Scale (SRS) total raw score relative to the Visit 1 total raw score.
Weight based dose limits were selected in this study to ensure that exposure in terms of area under the curve (AUC) was less than the predefined limit of 2100 ng·h/mL which represents a 10-fold lower exposure than observed at the No observed adverse effect level (NOAEL) of 15 mg/kg/day in juvenile rats.
The weight-based dose limits in this study were as follows:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Memantine Hydrochloride (HCl) | Experimental | Once daily oral administration of open-label memantine for up to 48 weeks: 6-week dose-titration period followed by up to 42-week maintenance period. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Memantine Hydrochloride (HCl) | Drug | Memantine extended release 3-mg capsules; the dosages studied ranged from 3 - 15 mg/day; weight based dosing in 4 weight groups; oral administration. Dosing is once daily for up to 48 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Confirmed Social Responsiveness Scale (SRS) Responders | A confirmed SRS responder was defined as a patient who had at least 12 weeks of exposure to memantine, and a ≥ 10-point reduction in the SRS total raw score relative to baseline at 2 consecutive visits separated by at least 2 weeks. The SRS is a 65-item, caregiver-rated assessment scale that measures observable items on social behavior and social language use, as well as characteristics of autism in a naturalistic social setting. Each item is rated on a scale from 0 (never true) to 3 (almost always true). The SRS total raw score ranges from 0 to 195; a higher score indicates greater severity of social impairment. | Visit 1 (Baseline) to Visit 8 (week 48/Final Visit) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jordan Lateiner, MS, MBA | Forest Research Institute, Inc.- A Subsidiary of Forest Laboratories, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Forest Investigative Site 068 | Dothan | Alabama | 36303 | United States | ||
| Forest Investigative Site 005 |
Enrolled patients went through a 2-week screening period.
Patient recruitment occurred over an eleven month period, from June of 2012 to May of 2013, at 118 study sites, located in the United States and 17 other countries.
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| ID | Title | Description |
|---|---|---|
| FG000 | Memantine Hydrochloride (HCl) | Memantine Hydrochloride (HCl) extended-release 3-mg capsules once daily oral administration. Dosing was 3-mg, 6-mg, 9-mg, 12-mg, or 15-mg per day, based upon patient weight. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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|
| Phoenix |
| Arizona |
| 85006 |
| United States |
| Forest Investigative Site 055 | Tucson | Arizona | 85718 | United States |
| Forest Investigative Site 077 | Little Rock | Arkansas | 72202-3591 | United States |
| Forest Investigative Site 054 | Glendale | California | 91206 | United States |
| Forest Investigative Site 109 | Imperial | California | 92251 | United States |
| Forest Investigative Site 066 | Irvine | California | 92612 | United States |
| Forest Investigative Site 096 | Los Angeles | California | 90024 | United States |
| Forest Investigative Site 021 | San Francisco | California | 94143-0984 | United States |
| Forest Investigative Site 026 | Santa Ana | California | 92701 | United States |
| Forest Investigative Site 002 | Stanford | California | 94305-5719 | United States |
| Forest Investigative Site 078 | Boulder | Colorado | 80304 | United States |
| Forest Investigative Site 073 | Centennial | Colorado | 80112 | United States |
| Forest Investigative Site 052 | Washington D.C. | District of Columbia | 20010-2970 | United States |
| Forest Investigative Site 075 | Bradenton | Florida | 32751 | United States |
| Forest Investigative Site 080 | Gainesville | Florida | 32607 | United States |
| Forest Investigative Site 117 | Jacksonville | Florida | 32216 | United States |
| Forest Investigative Site 065 | Maitland | Florida | 32751 | United States |
| Forest Investigative Site 118 | Miami | Florida | 33155 | United States |
| Forest Investigative Site 085 | Oakland Park | Florida | 33334 | United States |
| Forest Investigative Site 115 | Orange City | Florida | 32763 | United States |
| Forest Investigative Site 124 | Orlando | Florida | 32803 | United States |
| Forest Investigative Site 125 | Orlando | Florida | 32803 | United States |
| Forest Investigative Site 062 | Orlando | Florida | 32806 | United States |
| Forest Investigative Site 114 | Orlando | Florida | 32839 | United States |
| Forest Investigative Site 067 | Tampa | Florida | 33612 | United States |
| Forest Investigative Site 101 | Wellington | Florida | 33414 | United States |
| Forest Investigative Site 102 | Libertyville | Illinois | 60048 | United States |
| Forest Investigative Site 023 | Naperville | Illinois | 60563 | United States |
| Forest Investigative Site 082 | Evansville | Indiana | 47713 | United States |
| Forest Investigative Site 123 | Fort Wayne | Indiana | 46805 | United States |
| Forest Investigative Site 056 | Indianapolis | Indiana | 46260 | United States |
| Forest Investigative Site 084 | Indianapolis | Indiana | 46260 | United States |
| Forest Investigative Site 106 | Wichita | Kansas | 67214-3199 | United States |
| Forest Investigative Site 061 | Louisville | Kentucky | 40202 | United States |
| Forest Investigative Site 074 | Owensboro | Kentucky | 42301 | United States |
| Forest Investigative Site 095 | Lake Charles | Louisiana | 70605 | United States |
| Forest Investigative Site 091 | New Orleans | Louisiana | 70112 | United States |
| Forest Investigative Site 086 | Rockville | Maryland | 20852 | United States |
| Forest Investigative Site 059 | Newton | Massachusetts | 02459 | United States |
| Forest Investigative Site 108 | Springfield | Massachusetts | 01199 | United States |
| Forest Investigative Site 116 | Lincoln | Nebraska | 68516 | United States |
| Forest Investigative Site 097 | Lincoln | Nebraska | 68526 | United States |
| Forest Investigative Site 130 | Henderson | Nevada | 89052 | United States |
| Forest Investigative Site 104 | Las Vegas | Nevada | 89128 | United States |
| Forest Investigative Site 136 | Neptune City | New Jersey | 07753 | United States |
| Forest Investigative Site 127 | Toms River | New Jersey | 08755 | United States |
| Forest Investigative Site 081 | Albuquerque | New Mexico | 87108-5129 | United States |
| Forest Investigative Site 107 | Albuquerque | New Mexico | 87109 | United States |
| Forest Investigative Site 098 | The Bronx | New York | 10467 | United States |
| Forest Investigative Site 072 | Chapel Hill | North Carolina | 27514 | United States |
| Forest Investigative Site 069 | Avon Lake | Ohio | 44012 | United States |
| Forest Investigative Site 001 | Columbus | Ohio | 43210 | United States |
| Forest Investigative Site 019 | Oklahoma City | Oklahoma | 73116 | United States |
| Forest Investigative Site 092 | Tulsa | Oklahoma | 74104 | United States |
| Forest Investigative Site 053 | Gresham | Oregon | 97030 | United States |
| Forest Investigative Site 132 | Johnstown | Pennsylvania | 15904 | United States |
| Forest Investigative Site 131 | McMurray | Pennsylvania | 15317 | United States |
| Forest Investigative Site 100 | Media | Pennsylvania | 19063 | United States |
| Forest Investigative Site 105 | Charleston | South Carolina | 29407 | United States |
| Forest Investigative Site 090 | Memphis | Tennessee | 38119 | United States |
| Forest Investigative Site 057 | Nashville | Tennessee | 37232 | United States |
| Forest Investigative Site 051 | Houston | Texas | 77090 | United States |
| Forest Investigative Site 070 | The Woodlands | Texas | 77381 | United States |
| Forest Investigative Site 028 | Clinton | Utah | 84015 | United States |
| Forest Investigative Site 141 | Ogden | Utah | 84405 | United States |
| Forest Investigative Site 029 | Salt Lake City | Utah | 84106 | United States |
| Forest Investigative Site 064 | Charlottesville | Virginia | 22903 | United States |
| Forest Investigative Site 113 | Norfolk | Virginia | 23507 | United States |
| Forest Investigative Site 071 | Bothell | Washington | 98011 | United States |
| Forest Investigative Site 119 | Charleston | West Virginia | 25304 | United States |
| Forest Investigative Site 063 | Middleton | Wisconsin | 53562 | United States |
| Forest Investigative Site 177 | Camperdown | New South Wales | 2050 | Australia |
| Forest Investigative Site 204 | Brussels | 1020 | Belgium |
| Forest Investigative Site 203 | Brussels | 1090 | Belgium |
| Forest Investigative Site 202 | Hoboken | 2660 | Belgium |
| Forest Investigative Site 201 | Leuven | 3000 | Belgium |
| Forest Investigative Site 155 | Toronto | Ontario | M5B 1T8 | Canada |
| Forest Investigative Site 227 | Barranquilla | Colombia |
| Forest Investigative Site 228 | Bello | Colombia |
| Forest Investigative Site 226 | Bogotá | Colombia |
| Forest Investigative Site 276 | Tallinn | 10617 | Estonia |
| Forest Investigative Site 329 | Bron | Rhone | 69500 | France |
| Forest Investigative Site 326 | Paris | 75935 | France |
| Forest Investigative Site 379 | Budapest | 1021 | Hungary |
| Forest Investigative Site 381 | Budapest | 1026 | Hungary |
| Forest Investigative Site 376 | Budapest | 1083 | Hungary |
| Forest Investigative Site 378 | Budapest | 1089 | Hungary |
| Forest Investigative Site 382 | Gyula | 5700 | Hungary |
| Forest Investigative Site 380 | Szeged | 6725 | Hungary |
| Forest Investigative Site 401 | Kopavogur | 200 | Iceland |
| Forest Investigative Site 453 | Roma | Roma | 165 | Italy |
| Forest Investigative Site 452 | Siena | Siena | 53100 | Italy |
| Forest Investigative Site 526 | Wellington | 6012 | New Zealand |
| Forest Investigative Site 579 | Gdansk | 80-542 | Poland |
| Forest Investigative Site 578 | Gdansk | 80-952 | Poland |
| Forest Investigative Site 580 | Kielce | 25-317 | Poland |
| Forest Investigative Site 576 | Kobierzyce | 55-040 | Poland |
| Forest Investigative Site 577 | Warsaw | 02-957 | Poland |
| Forest Investigative Site 626 | Belgrade | 11000 | Serbia |
| Forest Investigative Site 627 | Belgrade | 11000 | Serbia |
| Forest Investigative Site 629 | Niš | 18000 | Serbia |
| Forest Investigative Site 628 | Novi Sad | 21000 | Serbia |
| Forest Investigative Site 651 | Singapore | 539747 | Singapore |
| Forest Investigative Site 676 | Cape Town | Western Cape | 7530 | South Africa |
| Forest Investigative Site 704 | Yangsan | Gyeongsangnam-do | 626-770 | South Korea |
| Forest Investigative Site 702 | Seoul | 110744 | South Korea |
| Forest Investigative Site 703 | Seoul | 120-752 | South Korea |
| Forest Investigative Site 701 | Seoul | 138-736 | South Korea |
| Forest Investigative Site 729 | Barcelona | Barcelona | 8221 | Spain |
| Forest Investigative Site 728 | Sabadell | Barcelona | 8208 | Spain |
| Forest Investigative Site 727 | Madrid | Madrid | 28031 | Spain |
| Forest Investigative Site 730 | Torremolinos | Málaga | 29620 | Spain |
| Forest Investigative Site 802 | Kherson | Vil. Stepanivka | 73488 | Ukraine |
| Forest Investigative Site 803 | Donetsk | 83008 | Ukraine |
| Forest Investigative Site 807 | Kharkiv | 61153 | Ukraine |
| Forest Investigative Site 804 | Kyiv | 4080 | Ukraine |
| Forest Investigative Site 801 | Odesa | 65014 | Ukraine |
| COMPLETED |
|
| NOT COMPLETED |
|
|
A total of 906 patients were enrolled in the open-label study. Of these, 903 patients received at least 1 dose of open-label treatment to comprise the Safety Population. 868 patients in the Safety Population also had at least 1 post-Visit 1 assessment of the SRS total raw score to comprise the Intent to Treat (ITT) population
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| ID | Title | Description |
|---|---|---|
| BG000 | Memantine Hydrochloride (HCl) | Memantine Hydrochloride (HCl) extended-release 3-mg capsules once daily, oral administration. Dosing was 3-mg, 6-mg, 9-mg, 12-mg, or 15-mg per day, based upon patient weight. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | Years |
| ||||||||||||||||||||||
| Sex/Gender, Customized | Number | participants |
| |||||||||||||||||||||||
| Race/Ethnicity, Customized | Number | participants |
| |||||||||||||||||||||||
| Region of Enrollment | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Confirmed Social Responsiveness Scale (SRS) Responders | A confirmed SRS responder was defined as a patient who had at least 12 weeks of exposure to memantine, and a ≥ 10-point reduction in the SRS total raw score relative to baseline at 2 consecutive visits separated by at least 2 weeks. The SRS is a 65-item, caregiver-rated assessment scale that measures observable items on social behavior and social language use, as well as characteristics of autism in a naturalistic social setting. Each item is rated on a scale from 0 (never true) to 3 (almost always true). The SRS total raw score ranges from 0 to 195; a higher score indicates greater severity of social impairment. | Of the 906 patients who enrolled in the study 903 received at least 1 dose of open-label treatment to comprise the Safety Population. The Intent to Treat (ITT) population included the 868 patients in the Safety population who also had at least 1 post-Visit 1 assessment of the SRS total raw score. | Posted | Number | participants | Visit 1 (Baseline) to Visit 8 (week 48/Final Visit) |
|
|
|
Adverse event data was collected over a 14 month period from June 2012 to August 2013 at 118 study sites in the US and 17 other countries.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Memantine Hydrochloride (HCl) | Memantine Hydrochloride (HCl) extended-release 3-mg capsules, oral administration. Dosing was 3-mg, 6-mg, 9-mg, 12-mg or 15-mg, once per day, based upon patient weight. | 6 | 903 | 196 | 903 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abnormal behaviour | Psychiatric disorders | MedDRA (15.0) | Systematic Assessment |
| |
| Accidental exposure | Injury, poisoning and procedural complications | MedDRA (15.0) | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | MedDRA (15.0) | Systematic Assessment |
| |
| Disinhibition | Psychiatric disorders | MedDRA (15.0) | Systematic Assessment |
| |
| Gastroenteritis | Gastrointestinal disorders | MedDRA (15.0) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pyrexia | General disorders | MedDRA (15.0) | Systematic Assessment |
| |
| Irritability | General disorders | MedDRA (15.0) | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA (15.0) | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
|
All data generated in this study are the property of Forest Research Institute, Inc. An integrated clinical and statistical report will be prepared at the completion of the study.
Publication of the results by the Investigator will be subject to mutual agreement between the Investigator and Forest Research Institute, Inc.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Joel Trugman, MD | Forest Research Institute | 201-427-8000 | 8681 | Joel.Trugman@frx.com |
| ID | Term |
|---|---|
| D000067877 | Autism Spectrum Disorder |
| D001321 | Autistic Disorder |
| D020817 | Asperger Syndrome |
| ID | Term |
|---|---|
| D002659 | Child Development Disorders, Pervasive |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D008559 | Memantine |
| ID | Term |
|---|---|
| D000547 | Amantadine |
| D000218 | Adamantane |
| D001952 | Bridged-Ring Compounds |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
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| Asian |
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| American Indian or Alaska Native |
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| Native Hawaiian or Other Pacific Islander |
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| Other |
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| Hispanic or Latino |
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| Not Hispanic or Latino |
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| Belgium |
|
| Canada |
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| Colombia |
|
| Estonia |
|
| France |
|
| Hungary |
|
| Iceland |
|
| Italy |
|
| Korea, Republic of |
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| New Zealand |
|
| Poland |
|
| Serbia |
|
| Singapore |
|
| South Africa |
|
| Spain |
|
| Ukraine |
|