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The program was shut down due to a lack of efficacy.
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Children between the ages of 6-12 years who are diagnosed with impulsive aggression comorbid with ADHD and have participated in the 810P301 or 810P302 study were invited to participate in this study. This was a Phase 3 open-label extension (OLE) study to collect long-term safety data on the use of SPN-810 in treating impulsive aggression in pediatric subjects with ADHD when taken in conjunction with standard ADHD treatment. After confirmation of eligibility, all subjects were treated with SPN-810. Subjects were given a choice to extend participation in this study every 6 months for up to 36 months.
Study 810P304 is a multicenter, open-label, extension study aimed to assess safety of SPN-810 in the treatment of IA in patients aged 6-17 years with ADHD in conjunction with standard ADHD treatment.
The study has three phases: Optimization, Maintenance, and Taper. All subjects who complete the randomized, double-blind portion of study 810P301, 810P302, 810P503 or 810P204 will have the option to participate in the OLE study in which all subjects will receive active Study Medication (SM) treatment. Subjects who choose to participate in the OLE will receive blinded conversion medication kits at Visit 6 of the previous SPN-810 double-blind randomization study (810P301, 810P302) or at Visit 4 for subjects completing the 810P204 study. Subjects, who have completed the 810P503 study and, chose to participate in this study, will receive the blinded conversion card at Visit 7.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Open-label treatment with SPN-810 | Experimental | Subjects aged 6-17 years were treated with SPN-810 starting on day 1 with 18 mg/day. The clinician was able to adjust the dose of SPN-810 throughout the study based on subject's response and tolerability within the limits of 6 mg/day and 36 mg/day or, up to 54 mg/day for subjects with a body weight ≥ 30 kg. The subjects were given a choice of extending their participation in the study every 6-month period for up to 36 months |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SPN-810 | Drug |
|
| Measure | Description | Time Frame |
|---|---|---|
| Effect of SPN810 on Retrospective-Modified Overt Aggression Scale (R-MOAS) Total Score | R-MOAS scale gauges the severity of aggressive behavior: the frequency of the 16 behaviors is rated over the past week in 4 areas (VE, PH, PR, SE). For each open question in each area, the parent-rated the aggressive behaviors on a scale from 0 to 5 or more times. To each area corresponds a weighted category: Verbal Incidents (VE)=1, Incidents Toward Other (PH) =4, Incidents Involving Property (PR)=2 and Incidents Directed Toward Self (SE)=3. Therefore, the sum of each area yields a maximum weighted score of 20 (VE), 120 (PH), 60 (PR), and 90 (SE). The total score is the sum of the four area scores or 0-290; the higher the score, the more severe the aggressive behavior is. The data represent the total score change from baseline at each visit for the duration of the study, a total of 60 months. The baseline score represents the total score at the last visit of each double-blind study. | 17-time points: Months 3 (V5), 6 (V6), 9 (V7), 12 (V8), 15 (V9), 18 (V10), 21 (V11), 24 (V12), 27 (V13), 30 (V14), 33 (V15), 36 (V16), 39 (V17), 42 (V18), 45 (V19), 48 (V20) and month 60 (Visit 24). |
| Effect of SPN810 on Impulsive Aggression (IA) Measured by Clinical Global Impression - Severity Scale (CGI-S) | The Clinical Global Impression - Severity of Illness (CGI-S) is a single item clinician rating of clinician's assessment of the severity of IA behaviors. CGI-S was evaluated by the Investigator at each visit on a 7- point scale with 1=Normal, 2=Borderline ill, 3=Mildly ill, 4=Moderately ill, 5=Markedly ill, 6=Severely ill, and 7=Extremely ill. Data represent the change from baseline to each visit during the study. The baseline score represents the total score at the last visit of each double-blind study. | 20-time points: Week 2 (V2), Week 4 (V3), Week 8 (V4), Months 3 (V5), 6 (V6), 9 (V7), 12 (V8), 15 (V9),18 (V10), 21 (V11), 24 (V12), 27 (V13), 30 (V14), 33 (V15), 36 (V16), 39 (V17), 42 (V18), 45 (V19), 48 (V20) and month 60 (Visit 24). |
| Effect of SPN810 on Impulsive Aggression (IA) Measured by Clinical Global Impression - Improvement Scale (CGI-I) | The Clinical Global Impression - Improvement Scale (CGI-I) is a clinician's assessment of how much the IA behaviors have improved or worsened relative to a baseline state at the beginning of treatment. CGI-I was evaluated by the Investigator at each visit on a 7-point scale with 1=Very much improved, 2= Much improved, 3= Minimally improved, 4= No change, 5= Minimally worse, 6= Much worse, 7= Very much worse. Data represent the score at each visit during the study. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gianpiera Ceresoli-Borroni, PhD | Supernus Pharmaceuticals, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CNS Healthcare of Orlando | Orlando | Florida | 32801 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | <18 mg SPN-810 | Subjects treated with 6, 12 or 15 mg/day SPN-810. |
| FG001 | 18 mg to < 24 mg SPN-810 | Subjects treated with 18 mg/day, or 21 mg/day SPN-810 |
| FG002 | 24 mg to < 36 mg SPN-810 | Subjects treated with 24, 27 or 30 mg/day SPN-810 |
| FG003 | 36 mg to ≤54 mg SPN-810 | Subjects treated with 36, 42, 45, 48 or 54 mg/day SPN-810 |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Safety Population: Safety population is defined as all subjects who received at least 1 dose of study drug during the study.
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| ID | Title | Description |
|---|---|---|
| BG000 | <18 mg SPN-810 | Subjects treated with 6,12 or 15 mg/day SPN-810 |
| BG001 | 18 mg to <24 mg SPN-810 | Subjects treated with 18 mg/day or 21 mg/day SPN-810 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Effect of SPN810 on Retrospective-Modified Overt Aggression Scale (R-MOAS) Total Score | R-MOAS scale gauges the severity of aggressive behavior: the frequency of the 16 behaviors is rated over the past week in 4 areas (VE, PH, PR, SE). For each open question in each area, the parent-rated the aggressive behaviors on a scale from 0 to 5 or more times. To each area corresponds a weighted category: Verbal Incidents (VE)=1, Incidents Toward Other (PH) =4, Incidents Involving Property (PR)=2 and Incidents Directed Toward Self (SE)=3. Therefore, the sum of each area yields a maximum weighted score of 20 (VE), 120 (PH), 60 (PR), and 90 (SE). The total score is the sum of the four area scores or 0-290; the higher the score, the more severe the aggressive behavior is. The data represent the total score change from baseline at each visit for the duration of the study, a total of 60 months. The baseline score represents the total score at the last visit of each double-blind study. | Safety Population: Safety population is defined as all subjects who received at least 1 dose of study drug during the study. | Posted | Mean | Standard Deviation | score on a scale | 17-time points: Months 3 (V5), 6 (V6), 9 (V7), 12 (V8), 15 (V9), 18 (V10), 21 (V11), 24 (V12), 27 (V13), 30 (V14), 33 (V15), 36 (V16), 39 (V17), 42 (V18), 45 (V19), 48 (V20) and month 60 (Visit 24). |
Adverse events were collected at each study visit: Visit 1 (last visit in the double-blind study), weeks 2,4 and 8, and Months 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48 and 60 (months).
Adverse events reporting pertains to the Safety Population, defined as all subjects who received at least 1 dose of study drug during the study.
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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 | <18 mg SPN-810 | Subjects treated with 6, 12 or 15 mg/day SPN-810 | 0 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Suicidal Ideation | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nasopharyngitis | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gianpiera Ceresoli-Borroni/ Director Clinical Development | Supernus Pharmaceuticals | 3018382521 | gceresoliborroni@supernus.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Feb 22, 2019 | Jan 5, 2024 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 5, 2024 | Jan 8, 2024 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| 20-time points: Week 2 (V2), Week 4 (V3), Week 8 (V4), Months 3 (V5), 6 (V6), 9 (V7), 12 (V8), 15 (V9),18 (V10), 21 (V11), 24 (V12), 27 (V13), 30 (V14), 33 (V15), 36 (V16), 39 (V17), 42 (V18), 45 (V19), 48 (V20) and Month 60 (Visit 24). |
| Withdrawal by Parent/Guardian |
|
| Lost to Follow-up |
|
| Adverse Event |
|
| Physician Decision |
|
| Lack of Efficacy |
|
| Protocol Violation |
|
| Sponsor terminated study, SM non-compliance, Site closure, Subjects relocated or hospitalized. |
|
| Missing |
|
| BG002 | 24 mg to <36 mg SPN-810 | Subjects treated with 24, 27 or 30 mg/day SPN-810 |
| BG003 | 36 mg to ≤54 mg SPN-810 | Subjects treated with 36, 42, 45, 48 or 54 mg/day SPN-810 |
| BG004 | Total | Total of all reporting groups |
| years |
|
| Age, Customized | Number | participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
|
|
|
| Primary | Effect of SPN810 on Impulsive Aggression (IA) Measured by Clinical Global Impression - Severity Scale (CGI-S) | The Clinical Global Impression - Severity of Illness (CGI-S) is a single item clinician rating of clinician's assessment of the severity of IA behaviors. CGI-S was evaluated by the Investigator at each visit on a 7- point scale with 1=Normal, 2=Borderline ill, 3=Mildly ill, 4=Moderately ill, 5=Markedly ill, 6=Severely ill, and 7=Extremely ill. Data represent the change from baseline to each visit during the study. The baseline score represents the total score at the last visit of each double-blind study. | Safety Population: Safety population is defined as all subjects who received at least 1 dose of study drug during the study. | Posted | Mean | Standard Deviation | score on a scale | 20-time points: Week 2 (V2), Week 4 (V3), Week 8 (V4), Months 3 (V5), 6 (V6), 9 (V7), 12 (V8), 15 (V9),18 (V10), 21 (V11), 24 (V12), 27 (V13), 30 (V14), 33 (V15), 36 (V16), 39 (V17), 42 (V18), 45 (V19), 48 (V20) and month 60 (Visit 24). |
|
|
|
| Primary | Effect of SPN810 on Impulsive Aggression (IA) Measured by Clinical Global Impression - Improvement Scale (CGI-I) | The Clinical Global Impression - Improvement Scale (CGI-I) is a clinician's assessment of how much the IA behaviors have improved or worsened relative to a baseline state at the beginning of treatment. CGI-I was evaluated by the Investigator at each visit on a 7-point scale with 1=Very much improved, 2= Much improved, 3= Minimally improved, 4= No change, 5= Minimally worse, 6= Much worse, 7= Very much worse. Data represent the score at each visit during the study. | Safety Population: Safety population is defined as all subjects who received at least 1 dose of study drug during the study. | Posted | Mean | Standard Deviation | score on a scale | 20-time points: Week 2 (V2), Week 4 (V3), Week 8 (V4), Months 3 (V5), 6 (V6), 9 (V7), 12 (V8), 15 (V9),18 (V10), 21 (V11), 24 (V12), 27 (V13), 30 (V14), 33 (V15), 36 (V16), 39 (V17), 42 (V18), 45 (V19), 48 (V20) and Month 60 (Visit 24). |
|
|
|
| 38 |
| 3 |
| 38 |
| 18 |
| 38 |
| EG001 | 18 mg to < 24 mg SPN-810 | Subjects treated with 18 mg/day or 21 mg/day SPN-810 | 0 | 159 | 5 | 159 | 56 | 159 |
| EG002 | 24 mg to < 36 mg SPN-810 | Subjects treated with 24, 27 or 30 mg/day SPN-810 | 0 | 131 | 5 | 131 | 56 | 131 |
| EG003 | 36 mg to ≤54 mg SPN-810 | Subjects treated with 36, 42, 45, 48 or 54 mg/day SPN-810 | 0 | 163 | 9 | 163 | 66 | 163 |
| Aggression | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
|
| Oppositional Defiant Disorder | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
|
| Suicide Attempt | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
|
| Appendicitis | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
|
| Agitation | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
|
| Mental Status Changes | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
|
| Infection | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
|
| Infectious Mononucleosis | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
|
| Pyelonephritis | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
|
| Brain Mass | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
|
| Upper respiratory tract infection | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
|
| Influenza | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
|
| Gastroenteritis | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
|
| Weight increased | Investigations | MedDRA (18.1) | Systematic Assessment |
|
| Blood prolactin increased | Investigations | MedDRA (18.1) | Systematic Assessment |
|
| Tic | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
|
| Somnolence | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
|
| Ligament sprain | Injury, poisoning and procedural complications | MedDRA (18.1) | Systematic Assessment |
|
| Fatigue | General disorders | MedDRA (18.1) | Systematic Assessment |
|
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (18.1) | Systematic Assessment |
|
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
|
| Hyperprolactinaemia | Endocrine disorders | MedDRA (18.1) | Systematic Assessment |
|
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