Adherence to Stimulant Treatment in Attention-Deficit Hyperactivity Disorder (ADHD) Patients (ASTA)

Phase 4TerminatedNCT00852059

Prof. Huss32 enrolled

Overview

This study determined to measure non-adherence assessed by the number of non-adherent days during the clinical trial of 100 days using the Medication Event Monitoring System (MEMS). Study Design: * prospective * multi-centric * open-label * randomized * active-controlled trial

The study is designed as a prospective, multi-centric, open-label, randomized, active-controlled trial. ADHD-children and adolescents of both sexes, 6-17 of age, effectively treated with stimulants are recruited in two centres. Over a naturalistic run-in phase of four weeks adherence to medication taken before randomisation is measured. In the subsequent controlled clinical trial 50% of the participants are randomized to extended release (ER) methylphenidate (Medikinet retard®) applied with breakfast, 50% are randomized to immediate release (IR) methylphenidate (Medikinet®) in the morning and 3-4 h later (clinical trial). To optimize ecological validity, no double-dummy technique is applied; the allocation to either study arm is non-blinded. According to the power calculation 106 patients will be randomized. The total duration of the study is 18 months. Starting with a run-in visit, each eligible patient is observed in the naturalistic run-in phase for four weeks. Subsequently, patients participate 100 days in the clinical trial starting with a baseline visit, an in between-visit and a final visit. Medical care is provided in the routine program of both study centres. To record the adherence, medication events are counted by Medication Event Monitoring System (MEMS).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

ADHD

Interventions

Immediate release methylphenidate (Medikinet®)DRUG

Treatment: methylphenidate in the morning and 3-4 h later (twice daily), immediate release

Extended release methylphenidate (Medikinet retard®)DRUG

Treatment: methylphenidate applied with breakfast(once daily), extended release

Eligibility

Sex: ALLMin age: 6 YearsMax age: 17 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Written informed consent (separately for children aged 6-11 years and 12-17 years) * Children and adolescents of both sexes aged 6 - 17 years * Confirmed diagnosis of ADHD by semi structured-clinical interview K-SADS * ADHDRS-IV-Parent Version (18-Item-Scale) raw score ≥ 1,5 SD above norm under non-medicated conditions (either drug holiday or prior to medication within the past 6 months) * Effective treatment with a stable dose of methylphenidate for at least one month (max. 60 mg/day) proved by a 25% symptom reduction in ADHD-RS under medication, compared to retrospective ADHD-RS without medication within the past 6 months. * Acceptance and capability to swallow capsules of product size, proved by an equally sized placebo provided by Medice®. * Sufficient knowledge of the German language * Adequate contraception in case of sexual activity Exclusion Criteria: * Contraindications against methylphenidate * Previous stable methylphenidate intake more than twice daily * All severe psychiatric disorders except oppositional defiant disorder (ODD) or conduct disorder. In order to reflect the usual co-morbid spectrum of ADHD, mild or moderate anxiety or depressive disorders are accepted in the study. * All severe somatic diseases as assessed by the baseline examination or medical history (including life-time history of epileptic disorders) * Pathological results for vital signs, blood pressure and pulse * Reported pathological results for ECG during the last 12 months * Reported pathological results for differential blood count and hepatic metabolism during the last 6 months * Indication for hospitalization * Suicidality (assessed by MADRS Item 10, Score ≥ 3) * IQ \< 70 (clinically assessed) * Any psychotropic co-medication * Detention in an institution on official or judicial ruling * Unwillingness to transmit pseudonym data according to German regulations * Simultaneous participation in another clinical trial according to German Drug Law (AMG)

Locations (1)

Universitätsmedizin der Johannes Gutenberg-Universität Mainz - Körperschaft des öffentlichen Rechts

Mainz, Germany

Outcomes

Primary Outcomes

Non-adherence assessed by the number of non-adherent days during the clinical trial of 100 days using the Medication Event Monitoring System (MEMS)

Time frame: 100 days

Secondary Outcomes

Number of non-adherent days measured by pill count

Time frame: 100 days

Time interval until a total number of 30 days of non-adherence is reached cumulatively during the clinical trial measured by MEMS

Time frame: 100 days

Quality of life during measured by Child Health Illness Profile - Child Edition (CHIP-CE) Score

Time frame: 100 days

The efficacy of stimulant treatment during the clinical trial measured by ADHD-Rating Scale- Parent Version Sum Score

Time frame: 100 days

Data from ClinicalTrials.gov

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