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.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
28
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. Specifically, the FDA has approved 45mg as the maximum adult dose. For a 60kg adult, this is 0.75mg/kg. There will be 14 weeks of active treatment.
There will be a 2 week period of placebo run-in.
Holland Bloorview Kids Rehabilitation Hospital
Toronto, Ontario, Canada
Safety of pioglitazone in children with ASD ages 5-12 years
This will be measured by the Clinical Global Impressions - Improvement Scale - Global (CGI-I-Global)
Time frame: 16 Weeks
Safety of pioglitazone in children with ASD ages 5-12 years
This will be measured by the Safety Monitoring Uniform Report Form (SMURF)
Time frame: 16 Weeks
Efficacy of outcome measure to be used in a follow-up multisite randomized control trial of pioglitazone in children with ASD
This will be measured by the Aberrant Behavior Checklist (ABC)
Time frame: 16 Weeks
Efficacy of outcome measure to be used in a follow-up multisite randomized control trial of pioglitazone in children with ASD
This will be measured the Social Responsiveness Scale (SRS)
Time frame: 16 Weeks
Efficacy of outcome measure to be used in a follow-up multisite randomized control trial of pioglitazone in children with ASD
This will be measured by the the Child Yale-Brown Obsessive-Compulsive Scale (CY-BOCS)
Time frame: 16 Weeks
Efficacy of outcome measure to be used in a follow-up multisite randomized control trial of pioglitazone in children with ASD
This will be measured by the Repetitive Behavior Scale - Revised (RBS-R)
Time frame: 16 Weeks
Efficacy of outcome measure to be used in a follow-up multisite randomized control trial of pioglitazone in children with ASD
This will be measured by the Behavioral Assessment System for Children (BASC-2)
Time frame: 16 Weeks
Efficacy of outcome measure to be used in a follow-up multisite randomized control trial of pioglitazone in children with ASD
This will be measured by the Child and Adolescent Symptom Inventory (CASI) - Anxiety Subscale
Time frame: 16 Weeks
Maximum tolerated dose to be used in the follow-up multisite randomized controlled trial
Maximum Tolerated Dose (MTD)
Time frame: 16 Weeks
Efficacy of pioglitazone on markers of inflammation (cytokine levels) and oxidative stress (superoxide dismutase, malonyl aldehydes)
Cytokine level and oxidative stress marker measurement
Time frame: 16 Weeks
Relationship between different doses and response to treatment
Pioglitazone dose and treatment response
Time frame: 16 Weeks
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