Attention Deficit Disorder With Hyperactivity Clinical Trial
Official title:
An Open International Multicentre Long-Term Follow Up Study to Evaluate Safety of Prolonged Release OROS Methlyphenidate in Adults With Attention Deficit Hyperactivity Disorder
Trial 42603ATT3004 is an open-label extension study to clinical trial 42603ATT3002
(NCT00246220). In trial 42603ATT3002 the efficacy and safety of OROS methylphenidate was
assessed in adult subjects with Attention Deficit Hyperactivity Disease (ADHD). ADHD is a
developmental disorder beginning in childhood and characterized by developmentally
inappropriate inattention, hyperactivity and impulsiveness. Data on the number of adult
patients with ADHD is limited, but it is estimated that approximately 50% of children with
ADHD will have symptoms also in adhulthood. The drug tested in this trial is OROS
methylphenidate. The active ingredient is methylphenidate and the tablet is designed to
release the active ingredient gradually to ensure an effect, which lasts up to 12 hours.
Trial 42603ATT3002 consisted of a 5-week period, where subjects were assigned to either
receive placebo (empty drug) or one out of three different dosages of OROS methylphenidate.
This 5-week period was followed by a 7-week period, where patients received OROS
methylphenidate at their optimal dose. In study 42603ATT3004, subjects who complete
42603ATT3002 are followed for a period of at least 52 weeks to evaluate safety and
tolerability of OROS methylphenidate in patients who are treated with OROS methylphenidate
over a long period of time.
Amendment: At the end of the open-label period of the present study 42603ATT3004, patients
are enrolled into a double-blind placebo-controlled period, which lasts an additional 4
weeks. The purpose of this double-blind placebo-controlled period is to evaluate the
maintenance of effect under continued treatment with OROS methlyphenidate in comparison to
treatment cessation in those patients, who are randomized into the placebo-group.
This is an open label, multicentre extension study to trial 42603ATT3002. Patients, who were
enrolled to trial 42603ATT3002 must have had a diagnosis of ADHD with some symptoms already
present at the age of 7 and continuing in adulthood. The patients must have had at least
mild to moderate symptoms of ADHD. In trial 42603ATT3002 the efficacy and safety of three
fixed dosages of the study drug OROS methlyphenidate (MPH) was compared with placebo in
adult subjects with ADHD in a double-blind phase. This double-blind phase was followed by an
open-label phase, which was designed to assess the safety and tolerabiltiy of the study drug
OROS methylphenidate in these subjects, when they got a dose, which was optimal to control
their symptoms. In trial 42603ATT3004 patients are enrolled who completed the open-label
phase of trial 42603ATT3002. Trial 42603ATT3004 is designed to assess the long-term safety
and tolerabilty of OROS methylphenidate over a period of 52 weeks at a dose, which is
optimal to control the symptoms. Patients may enter the extension study 42603ATT3004 at
Visit 8 (End-of-Phase Visit, Open Label) of the 42603ATT3002 study as long as the patient
has given informed consent prior to the visit being performed. Visit 8 data may then serve
as baseline data for the extension study. These patients should continue treatment at the
same optimal dosage of PR OROS methylphenidate as was attained during the open label phase
of protocol 42603ATT3002. Patients who complete the 42603ATT3002 study, including post-study
visit, may enter the extensions study up to 30 calendar days from the last dosing of open
label trial medication of the 42603ATT3002 study. Patients should be titrated accordingly to
their optimal dose attained in study 42603ATT3002. Patients will be assessed at regular
intervals for at least 52 weeks.
Amendment: At completion of the open-label phase, patients can participate in a double-blind
placebo-controlled phase, provided that they are giving written informed consent. At
inclusion to the double-blind placebo-controlled phase, patients are assigned to one of two
treatment arms by chance. One treatment arm will continue taking the same treatment at the
same daily dose as during the open-label period. The other treatment arm will receive
placebo treatment. As placebo, an inactive formulation or an empty treatment will be used.
During the double-blind placebo-controlled phase, patients are asked to return to their
doctor's office every other week. During these visits, physical examinations will be made,
efficacy measures will be taken by means of questionnaires, that need to be completed either
by the treating physician or the patient and any unwanted side effect will be recorded and
treated if needed. One week after the end of the double-blind, placebo-controlled phase,
patients have to return one more time to their doctor's office for the so called post-study
visit, during which an additional physical examination will be performed and additional
safety and efficacy parameters will be assessed.Patients will be assessed at regular
intervals for at least 52 weeks. Daily oral dosages of 18, 36, 54, 72 and 90mg will be
available and may be increased or decreased by 18mg increments based on clinical
observations of response and tolerability for at least 52 weeks. Amendment: During the
double-blind, placebo-controlled phase, patients will receive either active treatment at the
previously assessed optimal dose or placebo tablets for a total of 4 weeks. Both treatments
(active or placebo) are taken by mouth once per day in the morning.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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