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Attention Deficit Hyperactivity Disorder (ADHD)Phase 3NCT03260205

Safety and Efficacy Study in Preschool Children Aged 4-5 Years With Attention-deficit/Hyperactivity Disorder (ADHD)

A Phase 3 study testing SPD489 (Lisdexamfetamine dimesylate) and SPD489 in people with Attention Deficit Hyperactivity Disorder (ADHD), run by Shire at 48 sites in United States.

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

The purpose of this study is to determine if an investigational treatment is effective in improving the total score on the ADHD-RS-IV Preschool Version in children 4-5 years old diagnosed with ADHD. Read more about this study

Who is it for?
Ages 4 to 5 years
What is being tested?
SPD489 (Lisdexamfetamine dimesylate) and SPD489
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
199 participants
Where
48 sitesUnited States
Study dates
6 Sep 2017to 23 Oct 2018
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 4 to 5 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Participant is a male or female aged 4-5 years inclusive at the time of consent
  • Participant's parent(s) or legally authorized representative (LAR) must provide signature of informed consent, and there must be documentation of assent (if applicable) by the participant before completing any study related procedures.
  • Participant and parent(s)/LAR are willing and able to comply with all of the testing and requirements defined in the protocol, including oversight of morning dosing.
  • Participant must meet DSM-IV-TR criteria for a primary diagnosis of ADHD (any sub-type).
  • Participant has an ADHD-RS-IV Preschool Version Total Score at the baseline visit (Visit 0) greater than or equal to 28 for boys, and greater than or equal to 24 for girls.
  • Participant has a Clinical Global Impressions - Severity of Illness (CGI-S) score greater than or equal to 4 at the baseline visit (Visit 0).
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  • Participant has a Peabody Picture Vocabulary Test standard score of greater than or equal to 70 at the screening visit (Visit -1).
  • Participant has undergone an adequate course of non-pharmacological treatment or has a severe enough condition to consider enrollment without undergoing prior non-pharmacological treatment.
  • Participant has participated in a structured group activity (e.g, preschool, sports, Sunday school) so as to assess symptoms and impairment in a setting outside the home.
  • Participant has lived with the same parent(s) or guardian for greater than or equal to 6 months.

Who cannot join

  • Participant is required to or anticipates the need to take any prohibited medications or medications that have central nervous system (CNS) effects or have an effect on performance. Stable use of bronchodilator inhalers is not exclusionary.
  • Participant has taken another investigational product or has taken part in a clinical study within 30 days prior to the screening visit (Visit -1).
  • Participant is well-controlled on his/her current ADHD medication with acceptable tolerability.
  • Participant has a concurrent chronic or acute illness, disability, or other condition that might confound the results of safety assessments or may increase risk to the participant..
  • Participant has glaucoma.
  • Participant has failed to fully respond to an adequate course of amphetamine therapy.
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  • Participant has a documented allergy, hypersensitivity, or intolerance to amphetamine or to any excipients in the investigational product.
  • Participant has a known family history of sudden cardiac death or ventricular arrhythmia.
  • Participant has a blood pressure measurement greater than or equal to 95th percentile for age, sex, and height at the screening visit (Visit -1) or the baseline visit (Visit 0) or history of moderate or severe hypertension.
  • Participant has a known history of symptomatic cardiovascular disease, unexplained syncope, exertional chest pain,advanced arteriosclerosis, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems.
  • Participant has any clinically significant clinical laboratory abnormalities at the screening visit (Visit -1) or electrocardiogram (ECG) at screening visit (Visit-1) or baseline visit (Visit 0) based on investigator judgment.
  • Participant has current abnormal thyroid function, defined as abnormal thyroid stimulating hormone (TSH) and thyroxine (T4) at the screening visit (Visit -1). Treatment with a stable dose of thyroid medication for at least 3 months is permitted.
  • Participant has a current, controlled (requiring medication or therapy) or uncontrolled, co-morbid psychiatric disorder including but not limited to any of the below co-morbid Axis I disorders and Axis II disorders:
  • post-traumatic stress disorder or adjustment disorder ii. bipolar illness, psychosis, or a family history of these disorders iii. pervasive developmental disorder iv. obsessive-compulsive disorder (OCD) v. psychosis/schizophrenia vi. a serious tic disorder, or a family history of Tourette's disorder vii. Participant is currently considered a suicide risk in the opinion of the investigator, has previously made a suicide attempt, or has a prior history of, or is currently demonstrating active suicidal ideation.
  • a history of physical, sexual, or emotional abuse ix. any other disorder or agitated state that in the opinion of the investigator, contraindicates SPD489 or lisdexamfetamine dimesylate treatment or confound efficacy or safety assessments.
  • Participant has initiated behavioral therapy within 1 month of the baseline visit (Visit 0). Participant may not initiate behavioral therapy during the study.
  • Participant has a height less than equal to (<=) 5th percentile for age and sex at the screening visit (Visit -1).
  • Participant has a weight <= 5th percentile for age and sex at the screening visit (Visit -1).
  • Participant lives with anyone who currently abuses stimulants or cocaine.
  • Participant has a history of seizures (other than infantile febrile seizures).
  • Participant is taking any medication that is excluded per the protocol.

Trial locations and contacts

48 sites in 1 country.

48 sites in 1 country

United States48 sites
  • BioBehavioral Research of Austin

    Austin, Texas, 78759

  • Kennedy Krieger Institute

    Baltimore, Maryland, 21205

  • Rainbow Research Inc

    Barnwell, South Carolina, 29812

  • Northwest Clinical Research Center

    Bellevue, Washington, 98007

  • Carolina Clinical Trials, Inc.

    Charleston, South Carolina, 29407

  • University Hospitals Case Medical Center

    Cleveland, Ohio, 44106

  • Ericksen Research and Development

    Clinton, Utah, 84015

  • CMB Clinical Trials

    Colton, California, 92324

  • iResearch Atlanta LLC

    Decatur, Georgia, 30030

  • Avail Clinical Research, LLC

    DeLand, Florida, 32720

  • Harmonex, Inc

    Dothan, Alabama, 36303

  • Pediatric Associates of Fairfield, Inc

    Fairfield, Ohio, 45014

  • Sarkis Clinical Trials

    Gainesville, Florida, 32607

  • Cyn3rgy Research Center

    Gresham, Oregon, 97030

  • Bayou City Research Limited

    Houston, Texas, 77007

  • BI Research Center

    Houston, Texas, 77084

  • Red Oak Psychiatry Associates

    Houston, Texas, 77090

  • Sun Valley Research Center

    Imperial, California, 92251

  • Clinical Neuroscience Solutions, Inc.

    Jacksonville, Florida, 32256

  • Lake Charles Clinical Trials

    Lake Charles, Louisiana, 70629

  • Premier Psychiatric Reseach Institute, LLC

    Lincoln, Nebraska, 68526

  • Preferred Research Partners, Inc

    Little Rock, Arkansas, 72211

  • Alliance for Wellness d/b/a Alliance for Research

    Long Beach, California, 90807

  • Clinical Neuroscience Solutions, Inc

    Memphis, Tennessee, 38119

  • Coastal Carolina Research

    Mt. Pleasant, South Carolina, 29464

  • Jersey Shore University Medical Center (JSUMC)

    Neptune City, New Jersey, 07753

  • Manhattan Behavioral Medicine

    New York, New York, 10036

  • IPS Research Company

    Oklahoma City, Oklahoma, 73103

  • Oklahoma Clinical Research Center

    Oklahoma City, Oklahoma, 73112

  • Paradigm Research Professionals

    Oklahoma City, Oklahoma, 73118

  • Cutting Edge Research Group

    Oklahoma City, Oklahoma, 73120

  • Medical Research Group of Central Florida

    Orange City, Florida, 32763

  • Clinical Neuroscience Solutions

    Orlando, Florida, 32801

  • APG Research, LLC

    Orlando, Florida, 32803

  • Asclepes Research

    Panorama City, California, 91402

  • Clinical Research Partners, LLC

    Petersburg, Virginia, 23805

  • University of Rochester

    Rochester, New York, 14642

  • Rochester Center for Behavioral Medicine

    Rochester Hills, Michigan, 48306

  • Road Runner Research

    San Antonio, Texas, 78249

  • Psychiatric Centers at San Diego

    San Diego, California, 92108

  • UCSF Dept of Psychiatry

    San Francisco, California, 94143

  • Seattle Childrens Hospital, Pearl Clinic

    Seattle, Washington, 98105

  • Washington University

    St Louis, Missouri, 63110

  • University of South Florida

    St. Petersburg, Florida, 33701

  • Clinical Neurophysiology Services

    Sterling Heights, Michigan, 48314

  • University of South Florida Department Of Psychiatry

    Tampa, Florida, 33613

  • Family Psychiatry of the Woodlands

    The Woodlands, Texas, 77381

  • Elite Clinical Trials, Inc

    Wildomar, California, 92595

Other trials in United States

About this study

Official title: A Phase 3, Randomized, Double-blind, Multicenter, Parallel-group, Placebo-controlled, Fixed-Dose Safety and Efficacy Study of SPD489 Compared With Placebo in Preschool Children Aged 4-5 Years With Attention-deficit/Hyperactivity Disorder

The purpose of this study is to determine if an investigational treatment is effective in improving the total score on the ADHD-RS-IV Preschool Version in children 4-5 years old diagnosed with ADHD.

Being tested
Placebo, SPD489 (Lisdexamfetamine dimesylate), SPD489
Keywords
SPD489, Lisdexamfetamine dimesylate, ADHD, hyperactivity, Neurobehavioral disorder
Medical subject headings
Attention Deficit Disorder with Hyperactivity, Spasm

What participants receive

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

  • PlaceboDrug

    Placebo matching to SPD489 (Lisdexamfetamine dimesylate) capsule for 6 weeks.

  • SPD489 (Lisdexamfetamine dimesylate)Drug

    SPD489 capsule in a 5:5:5:5:6 ratio to 5, 10, 20, 30 mg orally once daily for 6 weeks.

  • SPD489Drug

    SPD489

Study groups in NCT03260205
Study groupRoleWhat they receive
PlaceboPlacebo comparatorParticipant will receive placebo matching to SPD489 (Lisdexamfetamine dimesylate) capsule for 6 weeks.
Receives: Drug: Placebo
SPD489 (Lisdexamfetamine dimesylate)ExperimentalParticipants will be randomized to receive SPD489 capsule in a 5:5:5:5:6 ratio to SPD489 5, 10, 20, 30 milligram (mg) orally once daily for 6 weeks. Dosing will begin with the lowest strength of SPD489 (5 mg), and will be titrated until the randomly assigned fixed-dose is reached.
Receives: Drug: SPD489 (Lisdexamfetamine dimesylate); Drug: SPD489

What is being measured

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

  1. Change From Baseline in Clinician-Administered Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) Preschool Version Total Score at Week 6

    ADHD-RS-IV Preschool Version was adapted from the ADHD Rating Scale-IV and provided examples appropriate for the developmental level of preschool children. The ADHD-RS-IV Preschool Version was an 18-item questionnaire that required the respondent to rate the frequency of occurrence of ADHD symptoms as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV-TR) criteria. Each item was scored on a 4-point scale ranging from 0 (never or rarely) to 3 (very often) with total scores ranging from 0-54. The 18 items were grouped into 2 subscales: hyperactivity/impulsivity (even numbered items 2-18) and inattentiveness (odd numbered items 1-17). Full analysis set (FAS) consisted of all participants in the safety analysis set who had at least 1 post-dose ADHD RS IV preschool version total score assessment.

    Measured: Baseline, Week 6

Secondary outcomes (11)
  1. Clinical Global Impressions Global Improvement (CGI-I) at Week 6

    CGI-I was an overall assessment of global symptom improvement by evaluation of the participant's condition severity and improvement over time. Scoring was done based on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse), where higher score reported worse condition. The scoring was elaborated as: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse. FAS consisted of all participants in the safety analysis set who had at least 1 post-dose ADHD RS IV preschool version total score assessment.

    Measured: Week 6

  2. Dose Response Relationship for Change From Baseline in ADHD-RS-IV Preschool Version Total Score in Preschool Children at Week 6

    Dose response relationship was evaluated by using the ADHD-RS Preschool Version Total Score. ADHD-RS-IV Preschool Version was adapted from the ADHD Rating Scale-IV and provided examples appropriate for the developmental level of preschool children. The ADHD-RS-IV Preschool Version was an 18-item questionnaire that requires the respondent to rate the frequency of occurrence of ADHD symptoms as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV-TR) criteria. Each item was scored on a 4-point scale ranging from 0 (never or rarely) to 3 (very often) with total scores ranging from 0-54. The 18 items were grouped into 2 subscales: hyperactivity/impulsivity (even numbered items 2-18) and inattentiveness (odd numbered items 1-17). Dose response analysis set consisted of all participants in the safety analysis set who had at least 1 valid primary efficacy measurement on the randomized target dose level of the investigational product.

    Measured: Baseline, Week 6

  3. Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

    An adverse event (AE) was any untoward medical occurrence in a clinical investigation participant administered a investigational product (IP) and that does not necessarily had a causal relationship with this treatment. TEAEs were defined as AEs that start or deteriorate on or after the date of the first dose of IP and no later than 3 days following the last dose of IP.

    Measured: From start of study drug administration up to follow-up (Week 7)

  4. Number of Participants With Potentially Clinically Significant Changes in Vital Signs

    Vital sign assessments included blood pressure (systolic and diastolic), average pulse rate. Number of participants with potentially clinically significant changes in vital signs were reported. mmHg represents millimetre of mercury in the outcome measure data.

    Measured: Week 6

  5. Change From Baseline in Height at Week 6

    Height was measured in inche without shoes, with the participant stood on a flat surface and with chin parallel to the floor.

    Measured: Baseline, Week 6

  6. Change From Baseline in Body Weight at Week 6

    Body weight was measured in percentile without shoes. Body weight percentile was normalized by sex and age using the Centers for Disease Control and Prevention (CDC) growth charts. Body weight percentiles were categorized as lesser than (<) 5th, 5th to < 95th, and greater than or equal to (>=) 95th percentiles. Change from baseline in body weight at Week 6 was reported.

    Measured: Baseline, Week 6

  7. Change From Baseline in Body Mass Index (BMI) at Week 6

    BMI was derived from height and weight. BMI percentile was normalized by sex and age using the CDC growth charts. BMI percentiles were categorized as: Underweight (BMI < 5th percentile); Healthy weight (BMI 5th percentile up to < 85th percentile); Overweight (BMI 85th percentile < 95th percentile); Obese (BMI >= 95th percentile). Change from baseline in body mass index at Week 6 was reported.

    Measured: Baseline, Week 6

  8. Number of Participants With Potentially Clinically Significant Changes in Clinical Laboratory Values

    Clinical laboratory evaluations included biochemistry and endocrinology, hematology, and urinalysis. Number of participants with potentially clinically significant changes in clinical laboratory values were reported. ULN in measure data represents upper limit of normal, mcmol/L represents to Micromoles Per Litre, > = represents greater than or equal to.

    Measured: Week 6

  9. Number of Participants With Potentially Clinically Significant Changes in Electrocardiogram (ECG) Parameters

    Number of participants with potentially clinically significant changes in ECG parameters were reported. QTcF interval represents QT Fridericia's Correction Formula interval, QTcB interval represents QTc corrected by Bazett's in measure data.

    Measured: Week 6

  10. Children's Sleep Habits Questionnaire (CSHQ) at Week 6

    Children's Sleep Habits Questionnaire was a tool designed to screen the most common sleep problems in children, and consisted of 33 items for scoring. The instrument evaluated the child's sleep based on behavior within 8 different subscales: bedtime resistance, sleep-onset delay, sleep duration, sleep anxiety, night walkings, parasomnias, sleep-disordered breathing, and daytime sleepiness. Each item receives a score from 1 (problem occurs rarely) to 3 (problem usually occurs); therefore, a higher score is the worse outcome. Scale ranges are as follows: bedtime resistance: 6 to 18, sleep onset delay: 1 to 3, sleep duration: 3 to 9, sleep anxiety: 4 to 12, night walkings: 3 to 9, parasomnias: 7 to 21, sleep-disordered breathing: 3 to 9, daytime sleepiness: 8 to 24, and total disturbance (items from all scales): 33 to 99.

    Measured: Week 6

  11. Number of Participants With a Positive Response Using Columbia Suicide Severity Rating Scale (C-SSRS)

    C-SSRS was semi-structured interview that captured the occurrence, severity, and frequency of suicide-related thoughts and behaviors during the assessment period. The interview included definitions and suggested questions to solicit the type of information needed to determine if a suicide-related thought or behavior occurred. The C-SSRS contained 2 required items pertaining to suicidal ideation, 4 required items pertaining to suicidal behavior, and 1 required item pertaining to non-suicidal but self-injurious behavior. In situations where there was a positive response to the screening questions, there were 8 additional suicidal ideation items and 4 additional suicidal behavior items which were completed. Thus, there was a maximum of 19 items to be completed. Here number of participants responded as yes to suicidal ideation or behaviour were reported.

    Measured: Up to Week 6

Timeline

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

  1. First posted24 Aug 2017
  2. Study start6 Sep 2017
  3. Primary completion23 Oct 2018
  4. Study completion23 Oct 2018

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
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
199 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03260205
Sponsor's protocol ID
SPD489-347
Status last verified
May 2021
First submitted
9 Aug 2017
Last updated
8 Jun 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement.

Publications

  • Farhat LC, Sugaya LS, Bloch MH, Childress A, Cortese S, Fatori D, Salum GA, Rohde LA, Polanczyk GV. Individual Participant Data Meta-Analysis: Moderators of Response to Stimulants for Preschool Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry. 2026 Jun;65(6):781-792. doi: 10.1016/j.jaac.2025.09.012. Epub 2025 Sep 18.

    PubMed 40975435
  • Childress AC, Lloyd E, Jacobsen L, Gunawardhana L, Johnson SA Jr, Findling RL. Efficacy and Safety of Lisdexamfetamine in Preschool Children With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry. 2022 Dec;61(12):1423-1434. doi: 10.1016/j.jaac.2022.03.034. Epub 2022 May 13.

    PubMed 35577034

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing SPD489 (Lisdexamfetamine dimesylate) and SPD489 in people with Attention Deficit Hyperactivity Disorder (ADHD), run by Shire at 48 sites in United States.

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 10 inclusion and 21 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 8 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 48 sites in United States. 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 18 Jan 2020). 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?

Change From Baseline in Clinician-Administered Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) Preschool Version Total Score at Week 6 (time frame: Baseline, Week 6). 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 NCT03260205, 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 8 Jun 2021.

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