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Attention Deficit Disorder With HyperactivityPhase 3NCT00307684

Open Label, Multicentre Extension Study of Protocol 42603ATT3002 to Evaluate Safety of Prolonged Release OROS Methlyphenidate in Adults With Attention Deficit Hyperactivity Disorder (ADHD)

A Phase 3 study testing double blind PR OROS methylphenidate and open label PR OROS methylphenidate in people with Attention Deficit Disorder With Hyperactivity, run by Janssen-Cilag International NV at 21 sites in 7 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

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). Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
double blind PR OROS methylphenidate and open label PR OROS methylphenidate
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
155 participants
Where
21 sitesin 7 countries
Study dates
Jan 2006to Jul 2008
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient has completed study CR002479 (42603ATT3002), according to protocol
  • Diagnosis of ADHD according to the Diagnostic and Statistical Manual of Mental Diseases, Fourth Edition (DSM-IV)1 and confirmed by the Conners' Adult ADHD Diagnostic Interview for DSM IV (CAADID)
  • Healthy on the basis of physical examination, medical history
  • Patient is able to comply with the study visit schedule and willing and able to complete the protocol-specified assessments
  • Amendment (double-blind placebo-controlled period): written informed consent
  • patient must have completed at least 52 weeks of open-label treatment and must have been on a stable daily dose of (PR) OROS methlyphenidate prior to inclusion to this phase

Who cannot join

  • Patient is known to be a non-responder to methylphenidate, or patient has a child known to be a non-responder to methylphenidate
  • Allergy or hypersensitivty to methlyphenidate
  • Any clinically unstable psychiatric condition including but not limited to the following: acute mood disorder, bipolar disorder, acute obsessive-compulsive disorder (OCD), Anti-social personality disorder, borderline personality disorder
  • Use of other anti-depressants (unless patient has been on a stable dosage during the 42603ATT3002 trial, in which case treatment may continue as long as dosage remains unchanged for the duration of the study) or mood stabilisers (e.g. anti-epileptics, lithium)
  • Any medication likely to interfere with safe administration of methylphenidate, or any conditions that are contraindicated for use of methlyphenidate

Trial locations and contacts

21 sites in 7 countries.

21 sites in 7 countries

Germany11 sites
  • Study site

    Ahrensburg

  • Study site

    Aschaffenburg

  • Study site

    Berlin

  • Study site

    Cologne

  • Study site

    Essen

  • Study site

    Freiburg I. Br.

  • Study site

    Homburg

  • Study site

    Mannheim

  • Study site

    Ottobrunn bei München

  • Study site

    Saarbrücken

  • Study site

    Würzburg

Other trials in Germany

Netherlands2 sites
  • Study site

    Nijmegen

  • Study site

    The Hague

Other trials in Netherlands

Norway2 sites
  • Study site

    Drammen

  • Study site

    Ottestad

Other trials in Norway

Portugal2 sites
  • Study site

    Cascais

  • Study site

    Porto

Other trials in Portugal

Switzerland2 sites
  • Study site

    Basel Bs

  • Study site

    Zurich

Other trials in Switzerland

France1 site
  • Study site

    Paris

Other trials in France

Spain1 site
  • Study site

    Barcelona

Other trials in Spain

About this study

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.

Read the detailed description

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.

Being tested
double blind placebo, double blind PR OROS methylphenidate, open label PR OROS methylphenidate
Keywords
Attention Deficit Hyperactivity Disorder, Adult, Long term safety, Efficacy, Quality of life
Medical subject headings
Attention Deficit Disorder with Hyperactivity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • double blind placeboDrug

    matching placebo tablets once daily for 4 weeks

  • double blind PR OROS methylphenidateDrug

    18, 36, 54,72 or 90 mg/day once daily for 4 weeks

  • open label PR OROS methylphenidateDrug

    Flexible dosage MPH (18 to 90 mg/day) for 72 weeks (108 weeks for Germany)

Study groups in NCT00307684
Study groupRoleWhat they receive
001Experimentalopen label PR OROS methylphenidate Flexible dosage MPH (18 to 90 mg/day) for 72 weeks (108 weeks for Germany)
Receives: Drug: open label PR OROS methylphenidate
002Experimentaldouble blind PR OROS methylphenidate 18 36 54 72 or 90 mg/day once daily for 4 weeks
Receives: Drug: double blind PR OROS methylphenidate
003Placebo comparatordouble blind placebo matching placebo tablets once daily for 4 weeks
Receives: Drug: double blind placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Frequency of Adverse Events (AEs) and Serious Adverse Events (SAEs)

    To evaluate the long term safety and tolerability of PR OROS MPH (18, 36, 54, 72 and 90 mg/day) in adults with Attention Deficit Hyperactivity Disorder (ADHD)

    Measured: Treatment duration for OL extended from 52 wks to 72 wks (International Amendment 2) or 108 wks in Germany. Treatment duration for double-blind (DB) randomized withdrawal: 4 weeks

  2. Change From DB Baseline in Conners' Adult ADHD Rating Scale (CAARS) Total Score at DB Endpoint

    To evaluate maintenance of treatment effects of PR OROS MPH vs. placebo as measured on CAARS.

    CAARS assesses ADHD symptoms and behaviors in adults. best value: 0 worst value: 54

    Endpoint: last available post-baseline assessment.

    Measured: DB baseline, DB endpoint

Secondary outcomes (5)
  1. Change From OL Baseline to OL Endpoint in Conners' Adult ADHD Rating Scale (CAARS) Total and Subscale Scores

    Long term efficacy of PR OROS MPH as assessed by investigator-rated CAARS total score, hyperactivity/impulsivity subscale score and inattention subscale score.

    Subscale scores: best value: 0, worst value: 27

    Measured: OL baseline, OL endpoint

  2. Change From OL Baseline in Clinical Global Impression Scale (CGI-S) Score at OL Endpoint

    Assessment of the long term effect on overall functioning measured by CGI-S best score: 1 worst score: 7

    Measured: OL baseline, OL endpoint

  3. Change From OL Baseline in Quality of Life, Enjoyment and Satisfaction Questionnaire (Q-LES-Q) Score at OL Endpoint

    Quality of life measured by Q-LES-Q best score: 100 worst score: 0

    Measured: OL baseline, OL endpoint

  4. Change From DB Baseline to DB Endpoint in CGI-S Score

    evaluation of treatment effects as rated by the investigator on the CGI-S scale. CGI-S is used to rate the severity of a subject's illness on a 7- point scale ranging from 1 (not ill) to 7 (extremely severe).

    Measured: DB baseline, DB endpoint

  5. Change From DB Baseline to DB Endpoint in CAARS Self Rated Scale (CAARS-S:S) Total Score

    Evaluation of treatment effects as rated by the subjects on the CAARS-S:S. best score: 0 worst score: 104

    Measured: DB baseline, DB endpoint

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Mar 2006 (estimated)
  2. Study startJan 2006
  3. Primary completionJul 2008
  4. Study completionJul 2008

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Single group
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
155 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00307684
Sponsor's protocol ID
CR011068
Status last verified
Apr 2014
First submitted
24 Mar 2006
Last updated
21 Apr 2014
Data monitoring committee
No

Publications

  • Boesen K, Paludan-Muller AS, Gotzsche PC, Jorgensen KJ. Extended-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev. 2022 Feb 24;2(2):CD012857. doi: 10.1002/14651858.CD012857.pub2.

    PubMed 35201607
  • Buitelaar JK, Trott GE, Hofecker M, Waechter S, Berwaerts J, Dejonkheere J, Schauble B. Long-term efficacy and safety outcomes with OROS-MPH in adults with ADHD. Int J Neuropsychopharmacol. 2012 Feb;15(1):1-13. doi: 10.1017/S1461145711001131. Epub 2011 Jul 29.

    PubMed 21798108

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing double blind PR OROS methylphenidate and open label PR OROS methylphenidate in people with Attention Deficit Disorder With Hyperactivity, run by Janssen-Cilag International NV at 21 sites in 7 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Apr 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in Germany, Netherlands, Norway, Portugal, Switzerland and 2 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 23 Feb 2010). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Frequency of Adverse Events (AEs) and Serious Adverse Events (SAEs) (time frame: Treatment duration for OL extended from 52 wks to 72 wks (International Amendment 2) or 108 wks in Germany. Treatment duration for double-blind (DB) randomized withdrawal: 4 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00307684, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Apr 2014.

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