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Fragile X SyndromePhase 2/3CONNECT-FXNCT03614663

Clinical Study Of caNNabidiol in childrEn and adolesCenTs With Fragile X (CONNECT-FX)

A Phase 2/3 study testing ZYN002 - Cannabidiol Transdermal Gel in people with Fragile X Syndrome, run by Zynerba Pharmaceuticals, Inc. at 21 sites in 3 countries.

Completed

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

Official record
Search all trials

Trial summary

This trial will evaluate the efficacy and safety of ZYN002, a clear cannabidiol gel that can be applied to the skin (called transdermal application) twice a day for the treatment of behavioral symptoms of Fragile X Syndrome (FXS). Read more about this study

Who is it for?
Ages 3 to 17 years
Conditions the study is for
Fragile X Syndrome
What is being tested?
ZYN002 - Cannabidiol Transdermal Gel
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
212 participants
Where
21 sitesin 3 countries
Study dates
12 Jun 2018to 14 Jun 2020
Phase
Phase 2/3
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 3 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Male or female children and adolescents aged 3 to less than 18 years, at the time of Screening.
  • Diagnosis of FXS through molecular documentation of FMR1 full mutation.
  • Judged to be in good health based on physical exam, 12-lead ECG and clinical laboratory test results.
  • Patients must be assessed by the Investigator as being moderately to severely impacted due to FXS.
  • Patients taking psychotropic medication(s) should be on a stable regimen of not more than two such medications for at least fours weeks preceding Screening and must maintain that regimen throughout the study.
  • If patients are receiving non-pharmacological, behavioral and/or dietary interventions, they must be stable and have been doing so for three months prior to screening.
  • Patients and parents/caregivers must be adequately informed of the nature and risks of the study and given written informed consent prior to Screening.
  • In the Investigator's opinion, patients and parents/caregivers are reliable and willing and able to comply with all protocol requirements and procedures.

Who cannot join

  • Females who are pregnant, nursing or planning a pregnancy.
  • Alanine aminotransferase (ALT), aspartate aminotransferase (AST) or total bilirubin levels greater than or equal to 2 times the upper limit of normal or alkaline phosphatase levels greater than or equal to 3 times the upper limit of normal.
  • Use of a strong inhibitor/inducer of CYP3A4 or sensitive substrate of CYP3A4.
  • Use of minocycline for 30 days prior to screening or throughout the study.
  • Use of any benzodiazepine at screening or throughout the study.
  • Use of THC or CBD-containing product within three months of Screening Visit or during the study.
Show all 14Show fewer
  • Change in pharmacologic or non-pharmacologic intervention during the course of the study.
  • Any skin disease or condition including eczema, psoriasis, melanoma, acne, contact dermatitis, scarring, imperfections, lesions, tattoos, or discoloration that may affect treatment application, application site assessments or absorption of the trial drug.
  • Patient is using the following ASMs: clobazam, phenobarbital, ethosuximide, felbamate or vigabatrin.
  • Patients has an advanced, severe or unstable disease that may interfere with the study outcome evaluations.
  • Patient has acute or progressive neurological disease, psychosis, schizophrenia or any other psychiatric disorder or severe mental abnormalities (other than FXS) that are likely to require changes in drug therapy or interfere with the study objectives or ability to adhere to protocol requirements.
  • Patient has suspected or confirmed cardiovascular disease, advanced arteriosclerosis, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, cardiac conduction problems, exercise-related cardiac events including syncope and pre-syncope, risk factors for Torsades de pointes (e.g. heart failure, hypokalemia, family history of Long QT Syndrome) or other serious cardiac problems.
  • History of treatment for, or evidence of drug abuse within the past year.
  • Patient responds "yes" to Question 4 or 5 on the C-SSRS (Children) during Screening or at any time on study.

Trial locations and contacts

21 sites in 3 countries.

21 sites in 3 countries

United States17 sites
  • Emory University School of Medicine

    Atlanta, Georgia, 30322

  • Kennedy Krieger Institute

    Baltimore, Maryland, 21205

  • Boston Children's Hospital

    Boston, Massachusetts, 02115

  • University of North Carolina

    Chapel Hill, North Carolina, 27510

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • University Hospitals Cleveland Medical Center

    Cleveland, Ohio, 44106

  • Children's Hospital of Colorado

    Denver, Colorado, 80045

  • Greenwood Genetic Center

    Greenville, South Carolina, 29605

  • Suburban Research Associates

    Media, Pennsylvania, 19063

  • Fragile X Center of Atlantic Health System

    Morristown, New Jersey, 07960

  • The Fragile X Spectrum Disorder Clinic at Icahn School of Medicine at Mount Sinai, Division of Medical Genetics

    New York, New York, 10029

  • Southwest Autism Research and Resource Center

    Phoenix, Arizona, 85006

  • Phoenix Children's Hospital

    Phoenix, Arizona, 85016

  • UC Davis Health System, MIND Institute

    Sacramento, California, 95817

  • University of Washington Center for Human Development and Disability

    Seattle, Washington, 98198

  • Central States Research

    Tulsa, Oklahoma, 74136

Other trials in United States

Australia3 sites
  • Lady Cilento Children's Hospital - South Brisbane

    Brisbane, Queensland, 4101

  • Genetics Clinics Australia

    Melbourne, Victoria, 3161

  • Westmead Children's Hospital

    Sydney, New South Wales, 2145

Other trials in Australia

New Zealand1 site
  • Wellington Hospital

    Wellington, 6021

Other trials in New Zealand

About this study

Official title: A Randomized, Double-Blind, Placebo-Controlled Multiple-Center, Efficacy and Safety Study of ZYN002 Administered as a Transdermal Gel to Children and Adolescents With Fragile X Syndrome

This trial will evaluate the efficacy and safety of ZYN002, a clear cannabidiol gel that can be applied to the skin (called transdermal application) twice a day for the treatment of behavioral symptoms of Fragile X Syndrome (FXS). Eligible participants will then participate in up to a 14 week treatment period, where all participants will receive placebo or active study drug. Patients ages 3 to < 18 years, will be eligible to participate.

Read the detailed description

This is a randomized, double-blind, placebo-controlled, multiple-center study, to assess the efficacy and safety of ZYN002, a pharmaceutically manufactured cannabidiol, formulated as a transdermal gel, for the treatment of children and adolescent with FXS. Approximately 204 male and female patients, ages 3 to < 18 years, will undergo a screening process. Eligible participants will be randomized 1:1 to either trial drug or placebo and will undergo a 14-week treatment period. Randomization will be stratified by gender, weight category and geographic region. All participants may receive placebo during the trial. Participants who are taking anti-seizure drugs may undergo an additional 1-2 weeks of blinded treatment to taper off study drug treatment. The assignment will be done by a computer generated system and neither the trial doctor or the participant or their caregivers will know which treatment is being given to them. The dose of the treatment will depend on the weight of the participants. If the participants weigh less than or equal to 35 kg, they will receive 2 sachets of the gel twice a day (1 sachet approximately every 12 hours) and if they weigh more than 35 kg, they will receive 4 sachets of gel per day (2 sachets approximately every 12 hours). Parents/ caregivers will be instructed on proper application of the gel. The gel will be applied to clean, dry, intact skin of the upper arms/ shoulders.

Blood samples will be collected for safety analysis of ZYN002. An independent analytical laboratory will also perform CGG repeat and methylation status analyses. Additionally, the parents/caregivers will be asked to complete some questionnaires. There will be other questionnaires and scales that will be completed at the site by the trial doctor.

After the final dose, patients will be followed weekly for 4 weeks by telephone, prior to discharge from the study.

Being tested
ZYN002 - Cannabidiol Transdermal Gel, Placebo Transdermal Gel
Medical subject headings
Fragile X Syndrome

What participants receive

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

  • ZYN002 - Cannabidiol Transdermal GelDrug

    Pharmaceutically manufactured. Cannabidiol formulated as a clear gel (transdermal delivery)

  • Placebo Transdermal GelOther

    Also called Placebo Comparator, Matching Placebo

    Placebo formulated as a clear gel (transdermal delivery)

Study groups in NCT03614663
Study groupRoleWhat they receive
ZYN002 - Cannabidiol transdermal gelExperimentalZYN002 supplied as a transdermal gel. Patients weighing less than or equal to 35 kg will be randomized to receive either 125 mg cannabidiol Q12H or placebo. Patients weighing greater than 35 kg will be randomized to receive 250 mg cannabidiol Q12H or placebo.
Receives: Drug: ZYN002 - Cannabidiol Transdermal Gel
Placebo transdermal gelPlacebo comparatorMatching ZYN002 placebo supplied as a transdermal gel.
Receives: Other: Placebo Transdermal Gel

What is being measured

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

  1. Aberrant Behavior Checklist-Community Fragile X Factor Structure (ABC-C FXS) Social Avoidance Subscale - Full Analysis Set

    The Aberrant Behavior Checklist-Community is a standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials. The range for score for the subscale is from 0 to 12, and a higher value indicates a worse outcome.

    Measured: Change from Baseline to end of treatment (Week 12)

  2. Aberrant Behavior Checklist-Community Fragile X Factor Structure (ABC-C FXS) Social Avoidance Subscale - Ad Hoc Analysis

    The Aberrant Behavior Checklist-Community is a standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials. The range for score for the subscale is from 0 and 12, and the higher score means a worse outcome.

    Measured: Change from baseline to end of treatment (Week 12)

Secondary outcomes (6)
  1. Aberrant Behavior Checklist-Community Fragile X Factor Structure (ABC-C FXS) Irritability Subscale - Full Analysis Set

    The Aberrant Behavior Checklist-Community is a standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials. The range for score for the subscale is between 0 and 54, and the higher score means a worse outcome.

    Measured: Change from baseline to end of treatment (Week 12)

  2. Aberrant Behavior Checklist-Community, Fragile X Factor Structure (ABC-C FXS) Socially Unresponsive/Lethargic Subscale - Full Analysis Set

    The Aberrant Behavior Checklist-Community is a standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials. The range for score for the subscale is from 0 and 39, and a higher mean indicates a worse outcome.

    Measured: Change from baseline to end of treatment (Week 12)

  3. Number of Participants With Any Improvement - Clinical Global Impressions- Improvement (CGI-I) - Full Analysis Set

    The Clinical Global Impressions- Improvement global improvement item is a 7-point Likert scale designed to measure behavioral symptomatic change at a specific time compared to baseline. CGI-I is a standard global measure of potential change with treatment in placebo-controlled pharmacotherapy trials in developmental disabilities. The score ranges form 1-very much improved to 7-very much worse. The percentage of patients with any improvement (minimally, much, very much improved) was assessed.

    Measured: Change in CGI-I at end of treatment (Week 12)

  4. Aberrant Behavior Checklist-Community Fragile X Factor Structure (ABC-C FXS) Irritability Subscale - Ad Hoc Analysis

    The Aberrant Behavior Checklist-Community is a standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials. The range for score for the subscale is between 0 and 54, and the higher score means a worse outcome.

    Measured: Change from baseline in ABC-C to end of treatment (Week 12)

  5. Aberrant Behavior Checklist-Community Fragile X Factor Structure (ABC-C FXS) Socially Unresponsive/Lethargic Subscale - Ad Hoc Analysis

    The Aberrant Behavior Checklist-Community is a standard parent/caregiver reported behavioral outcome measure for use in developmental disability clinical trials. The range for score for the subscale is from 0 to 39 , and the higher score means a worse outcome.

    Measured: Change from baseline in ABC-C to end of treatment (Week 12)

  6. Number of Participants With Any Improvement - Clinical Global Impressions- Improvement (CGI-I) - Ad Hoc Analysis

    The Clinical Global Impressions- Improvement global improvement item is a 7-point Likert scale designed to measure behavioral symptomatic change at a specific time compared to baseline. CGI-I is a standard global measure of potential change with treatment in placebo-controlled pharmacotherapy trials in developmental disabilities. The score ranges form 1-very much improved to 7-very much worse. The percentage of patients with any improvement (minimally, much, very much improved) was assessed.

    Measured: Change in CGI-I at end of treatment (Week 12)

Timeline

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

  1. First posted3 Aug 2018
  2. Study start12 Jun 2018
  3. Primary completion14 Jun 2020
  4. Study completion14 Jun 2020

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
212 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03614663
Sponsor's protocol ID
ZYN2-CL-016
Acronym
CONNECT-FX
Status last verified
Jul 2020
First submitted
10 Jul 2018
Last updated
6 Jul 2022
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Berry-Kravis E, Hagerman R, Budimirovic D, Erickson C, Heussler H, Tartaglia N, Cohen J, Tassone F, Dobbins T, Merikle E, Sebree T, Tich N, Palumbo JM, O'Quinn S. A randomized, controlled trial of ZYN002 cannabidiol transdermal gel in children and adolescents with fragile X syndrome (CONNECT-FX). J Neurodev Disord. 2022 Nov 25;14(1):56. doi: 10.1186/s11689-022-09466-6.

    PubMed 36434514
  • Heussler HS. Emerging Therapies and challenges for individuals with Angelman syndrome. Curr Opin Psychiatry. 2021 Mar 1;34(2):123-128. doi: 10.1097/YCO.0000000000000674.

    PubMed 33395098

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing ZYN002 - Cannabidiol Transdermal Gel in people with Fragile X Syndrome, run by Zynerba Pharmaceuticals, Inc. at 21 sites in 3 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 8 inclusion and 14 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 6 Jul 2022. 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 United States, Australia, New Zealand. 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 combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 16 Jun 2022). 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?

Aberrant Behavior Checklist-Community Fragile X Factor Structure (ABC-C FXS) Social Avoidance Subscale - Full Analysis Set (time frame: Change from Baseline to end of treatment (Week 12)). 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 NCT03614663, 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 6 Jul 2022.

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