Investigating the Effect of Vortioxetine in Adult ADHD Patients

Lundbeck

Status and phase: Completed; Phase 2

Conditions: Attention Deficit Hyperactivity Disorder

Treatments: Other: Placebo tablet; Drug: vortioxetine 20 mg tablet; Drug: vortioxetine 10 mg tablet

Study type: Interventional

Funder types: Industry

Identifiers

NCT02327013

15996A

Details and patient eligibility

About

The purpose is to determine the effect of vortioxetine treatment on ADHD symptoms in adult patients with ADHD in a 12 weeks study.

Full description

The study employed the Sequential Parallel Comparison Design (SPCD), a clinical study design which intend to increase signal detection by using two stages of treatment:

• Stage 1 - first 6 weeks of the 12-weeks treatment period (Visit 2/Baseline 1 to Visit 5/Week 6)
• Stage 2 - last 6 weeks of the 12-weeks treatment period (Visit 5/Baseline 2 to Visit 8/Week 12)

In Stage 1, patients were randomized to placebo or vortioxetine 10 or 20mg. Patients on vortioxetine 10 or 20mg/day during Stage 1 remained on the same treatment in Stage 2. Responders to placebo in Stage 1 remained on Placebo in Stage 2. Patients who were placebo non-responders during Stage 1, defined as patients with a <30% reduction in AISRS total score from Baseline 1, were re-randomized to placebo or vortioxetine 10 or 20mg/day in Stage 2.

Enrollment: 227 patients

Sex: All

Ages: 18 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The patient is willing and able to attend study appointments within the specified time windows.
• The patient is an outpatient.
• The patient is diagnosed with a primary diagnosis of ADHD according to the DSM-5™ classification.
• The patient has an AISRS total score ≥24.
• The patient has a CGI-S rating ≥4 (moderately ill or worse).

Exclusion criteria

• The patient has previously been treated with vortioxetine.
• The patient has any current psychiatric disorder (DSM-IV-TR™ criteria), other than ADHD, as assessed using the Mini International Neuropsychiatric Interview (MINI).
• The patient has a known first-degree relative with bipolar disorder.
• The patient suffers from intellectual disability as evaluated by the Wechsler Abbreviated Scale of Intelligence (WASI) II vocabulary and matrix.
• The patient suffers from organic mental disorders, or mental disorders due to a general medical condition (DSM-5™ criteria).
• The patient has reported current use of, or has tested positive for, drugs of abuse (opiates, methadone, cocaine, amphetamines [including ecstasy], barbiturates, benzodiazepines, and cannabinoids). If a patient tests positive for opiates due to incidental use of codeine containing medication, as assessed in a clinical interview, the drug screen may be repeated up to three weeks later but the retest result must be available from the central laboratory latest at Visit 2 and has to be negative for this patient to be eligible for enrolment. If a patient tests positive for amphetamines due to his/her ADHD current treatment, as confirmed by a clinical interview, the patient is eligible for enrolment provided this treatment is discontinued two weeks prior to the Baseline Visit.
• The patient has a history of two prior failed (<50% improvement in symptoms) adequate trials of ADHD treatment.
• The patient has any other disorder for which the treatment takes priority over treatment of ADHD or is likely to interfere with study treatment or impair treatment compliance.
• The patient has a history of moderate or severe head trauma or other neurological disorders or systemic medical diseases that are, in the investigator's opinion, likely to affect central nervous system functioning.
• The patient has attempted suicide within the last 6 months or is at significant risk of suicide (either in the opinion of the Investigator or defined as a "yes" to suicidal ideation questions 4 or 5 or answering "yes" to suicidal behaviour on the Columbia-Suicide Rating Scale (C-SSRS) within the last 12 months).

Other protocol defined inclusion and exclusion criteria do apply

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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227 participants in 3 patient groups, including a placebo group

vortioxetine 10 mg tablet

Experimental group

Description:

In Stage 1, patients will receive vortioxetine 10mg/day for 6 weeks. In Stage 2, patients who received vortioxetine 10mg/day in Stage 1 will continue on the same treatment for additionally 6 weeks. Placebo non-responders will be re-randomized to placebo, or vortioxetine 10 or 20mg/day for additionally 6 weeks.

Treatment:

Drug: vortioxetine 10 mg tablet

vortioxetine 20 mg tablet

Experimental group

Description:

In Stage 1, patients will receive vortioxetine 20mg/day for 6 weeks. In Stage 2, patients who received vortioxetine 20mg/day in Stage 1 will continue on the same treatment for additionally 6 weeks. Placebo non-responders will be re-randomized to placebo, or vortioxetine 10 or 20mg/day for additionally 6 weeks.

Treatment:

Drug: vortioxetine 20 mg tablet

Placebo tablet

Placebo Comparator group

Description:

In Stage 1, the patients will receive placebo for 6 weeks. In Stage 2, placebo responders will continue on placebo for additionally 6 weeks. Placebo non-responders will be re-randomized to placebo, or vortioxetine 10 or 20mg/day for additionally 6 weeks.

Treatment:

Other: Placebo tablet