Dose Finding Study of Pioglitazone in Children With Autism Spectrum Disorders (ASD)
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Purpose
The investigators propose a pilot, single blind, placebo run-in, dose finding study of pioglitazone in children with autism with the ultimate goal of identifying appropriate dosing and outcome measures for a larger follow-up randomized placebo controlled clinical trial. The specific aims of this study are: 1) To examine the safety of pioglitazone in children with autism spectrum disorders (ASD) ages 5-12 years; 2) To identify appropriate outcome measures to be used in a follow-up multisite randomized control trial of pioglitazone in children with ASD; 3) To determine the maximum tolerated dose to be used in the follow-up multisite randomized controlled trial; 4) To examine the effect of pioglitazone on markers of inflammation (cytokine levels) and oxidative stress (superoxide dismutase, malonyl aldehydes); 5) To explore the relationship between different doses and response to treatment.
| Condition | Intervention | Phase |
|---|---|---|
|
Autism Spectrum Disorders |
Drug: Pioglitazone |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | A Pilot Dose Finding Study of Pioglitazone in Children With ASD |
- Clinical Global Impression - Improvement (CGI-I) [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 35 |
| Study Start Date: | April 2013 |
| Estimated Study Completion Date: | November 2014 |
| Estimated Primary Completion Date: | November 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Pioglitazone |
Drug: Pioglitazone
A modified dose finding method will be used to determine safety and dose response among three dose levels (0.25mg/kg qd, 0.5mg/kg qd, and 0.75mg/kg qd). The dose has been based on the per weight maximum adult dose (see Dose Calculation Chart). Specifically, the FDA has approved 45mg as the maximum adult dose. For a 60kg adult, this is 0.75mg/kg.
|
Eligibility| Ages Eligible for Study: | 5 Years to 12 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female outpatients 5-12 years of age inclusive (see Note below).
- Meet Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria. DSM-IV criteria for Autistic Disorder or Asperger's Disorder (autism spectrum disorder) will be confirmed by a clinician with expertise with individuals with ASD. Best estimate Diagnosis will be reached using DSM-IV criteria, the Autism Diagnostic Observation Schedule (ADOS-G) and the Autism Diagnostic Interview-Revised (ADI-R).
- Have a Clinical Global Impression-Severity (CGI-S) score ≥ 4 (moderately ill) at Baseline.
- If already receiving stable non-pharmacologic educational, behavioural, and/or dietary interventions, have continuous participation during the preceding 3 months prior to Screening and will not electively initiate new or modify ongoing interventions for the duration of the study.
- Have normal physical examination and laboratory test results at Screening. If abnormal, the finding(s) must be deemed clinically insignificant by the Investigator.
Exclusion Criteria:
- Patients born prior to 35 weeks gestational age.
- Families without sufficient command of the English Language.
- Patients with any primary psychiatric diagnosis other than autism at Screening.
- Patients with a current neurological disease, including, but not limited to, movement disorder, tuberous sclerosis, fragile X, and any other known genetic syndromes.
- Pregnant female patients, female patients who are sexually active, female patients using the birth control pill for whatever reason.
- Patients with a medical condition that might interfere with the conduct of the study, confound interpretation of the study results, or endanger their own well-being. Patients with evidence or history of malignancy or any significant hematological, endocrine, cardiovascular (including any rhythm disorder), respiratory, renal, hepatic, or gastrointestinal disease. Patients with stable epilepsy (no seizures for 6 months) and on stable doses of antiepileptic medications (no changes in 3 months) will be allowed in the study.
- Patients taking psychoactive medication(s).
- Patients taking insulin.
- Patients unable to tolerate venipuncture procedures for blood sampling.
- Patients with parent(s)/caregiver(s) who smoke.
- Patients who have had previous bladder infection(s).
- Patients with a family history of bladder cancer.
Contacts and Locations| Contact: Amy Epstein, MA | 416-425-6220 ext 6515 | aepstein@hollandbloorview.ca |
| Canada, Ontario | |
| Holland Bloorview Kids Rehabilitation Hospital | Recruiting |
| Toronto, Ontario, Canada, M4G 1R8 | |
| Contact: Amy Epstein, MA 416-425-6220 ext 6515 aepstein@hollandbloorview.ca | |
| Principal Investigator: Evdokia Anagnostou, MD | |
| Principal Investigator: | Evdokia Anagnostou, MD | Holland Bloorview Kids Rehabilitation Hospital |
More Information
No publications provided
| Responsible Party: | Evdokia Anagnostou, Clinician Scientist, Anagnostou, Evdokia, M.D. |
| ClinicalTrials.gov Identifier: | NCT01205282 History of Changes |
| Other Study ID Numbers: | 10-002 |
| Study First Received: | September 16, 2010 |
| Last Updated: | April 3, 2013 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Anagnostou, Evdokia, M.D.:
|
ASD |
Additional relevant MeSH terms:
|
Autistic Disorder Child Development Disorders, Pervasive Mental Disorders Diagnosed in Childhood Mental Disorders |
Pioglitazone Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013