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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04821856
Registration number
NCT04821856
Ethics application status
Date submitted
25/03/2021
Date registered
30/03/2021
Titles & IDs
Public title
Evaluation of the Effectiveness of Cannabidiol in Treating Severe Behavioural Problems in Children and Adolescents With Intellectual Disability
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Scientific title
A Randomized Placebo-controlled Trial of Cannabidiol to Treat Severe Behavioral Problems in Children and Adolescents With Intellectual Disability
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Secondary ID [1]
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RCH HREC 70053
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Intellectual Disability
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Child Behavior Problem
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Condition category
Condition code
Mental Health
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Learning disabilities
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Mental Health
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Other mental health disorders
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Mental Health
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Cannabidiol Oil
Treatment: Drugs - Placebo
Experimental: Cannabidiol 100mg/ml - The starting dose of cannabidiol (CBD) will be 5 mg/kg/day and will be administered orally twice daily in doses of 2.5 mg/kg (up titration phase from day 1 to 7). After one week, the dose of CBD will be increased to 10 mg/kg/day in two daily doses of 5mg/kg (8-week maintenance phase from day 8 to 63). On completion of the maintenance phase the dose of CBD will be decreased to 5mg/kg/day for one week (day 64 to 70), after which the CBD administration will cease.
A ceiling dose of 1000mg/day will be administered to all participants weighing 100kg or greater. These participants will receive a dose of 500mg/day during up- and down-titration.
Doses will be rounded to the nearest 10mg (0.1mL).
Placebo comparator: Placebo - The control group will receive placebo medium-chain triglyceride (MCT) oil which is indistinguishable from the active medication in appearance, smell and taste.
Dose will be matched for volume to the cannabidiol arm, and administered twice daily for 10 weeks (including up- and down-titration).
Treatment: Drugs: Cannabidiol Oil
Cannabidiol (CBD) isolate 100mg/ml in MCT oil oral solution, manufactured by THC Pharma
Treatment: Drugs: Placebo
MCT oil and flavoring solution, also manufactured by THC Pharma
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the Aberrant Behavior Checklist-Irritability (ABC-I) subscale total score at day 64
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Assessment method [1]
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This is a 15 item parent-rated questionnaire, used to measure Severe Behavioral Problems in children
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Timepoint [1]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [1]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total scores of the four remaining subscales of the Aberrant Behavior Checklist (ABC) at day 64
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Assessment method [1]
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43 parent-rated items assessing: Social withdrawal, Stereotypic behavior, Hyperactivity/Noncompliance and Inappropriate Speech
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Timepoint [1]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [2]
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Comparison between the cannabidiol 100mg/ml and placebo arms of clinician ratings on the Clinical Global Impressions-Improvement at day 64. Data will be presented as the proportion of participants in each arm with a rating suggesting improvement
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Assessment method [2]
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This is a single item clinician-rated summary measure of improvement
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Timepoint [2]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [3]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total score of the Parent Rated Anxiety Scale-ASD at day 64
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Assessment method [3]
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This is a 25 item parent-rated measure of anxiety in youth with ASD
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Timepoint [3]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [4]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total score of the Child & Adolescent Scale of Participation at day 64
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Assessment method [4]
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This is a 20 item parent-rated questionnaire that includes sub-scales for participation in home, school, and community activities
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Timepoint [4]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [5]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the weighted total score of the Child Health Utility 9D (CHU-9D) at day 64
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Assessment method [5]
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This is a 9 item parent-rated, preference-weighted measure used to calculate quality adjusted life years for children
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Timepoint [5]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [6]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total score of the Sleep Disturbance Scale for Children at day 64
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Assessment method [6]
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This is a 26 item parent-rated questionnaire assessing sleep difficulties in children
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Timepoint [6]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [7]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total score of the Assessment of Quality of Life 4D (AQOL-4D) at day 64
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Assessment method [7]
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This is a 12 item self-report health-related instrument used to calculate quality adjusted life years for parents
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Timepoint [7]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [8]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total score of the Beach Center Family Quality of Life at day 64
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Assessment method [8]
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This is a 25 item parent report measure that includes subscales assessing family interaction, parenting, emotional and material wellbeing, and disability-related support.
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Timepoint [8]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [9]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total score of the Depression Anxiety Stress Scale-21 at day 64
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Assessment method [9]
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This is a 21 item self-rated assessment of parent mental health, including symptoms of depression, anxiety and stress
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Timepoint [9]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [10]
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Mean difference between the cannabidiol 100mg/ml and placebo arms on the total score of the Autism Parenting Stress Index at day 64
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Assessment method [10]
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This is a 13 item self-rated measure of 3 categories of stress drivers in parents: core social disability, difficult behavior, physical issues
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Timepoint [10]
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At day 64 (end of maintenance treatment period)
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Secondary outcome [11]
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The frequency of adverse events as reported on the modified version of the Liverpool Adverse Event Profile (LAEP) at day 64 will be summarised across the cannabidiol 100mg/ml and placebo arms
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Assessment method [11]
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Completed by the parent or guardian, the LAEP was designed to capture known side-effects of anti-epileptic medication. The modified version includes additional items to ascertain other known side-effects of CBD. This measure includes 34 items.
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Timepoint [11]
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At day 64 (end of maintenance treatment period)
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Eligibility
Key inclusion criteria
1. Males and females aged 6 - 18 years of age;
2. DSM-5 diagnosis of intellectual disability (ID):
1. Full scale IQ < 70 on standardized cognitive assessment. Testing results must be sighted by the investigators and performed within two years of enrollment. In the event that records of prior testing are unavailable or the assessment was more than 2 years prior, IQ will be estimated using the Wechsler Abbreviated Scale of Intelligence-II.
2. Deficit in adaptive function (basis for severity rating of ID in DSM-5) in at least one activity of life on the Vineland Adaptive Behavior Scales (derives scores in Communication, Daily Living Skills and Socialization domains, and a Global Adaptive score). If records of prior testing are unavailable or the assessment was more than 2 years prior, this will be completed by the parent or guardian.
3. SBP: Defined as scores of:
1. 18 or higher on the Aberrant Behavior Checklist-Irritability subscale (ABC-I), and
2. moderate or higher on the Clinical Global Impressions-Severity scale;
4. No changes in either medication or other interventions in the 4 weeks prior to randomization, and intention to remain on same dose for the duration of the study;
5. Written informed consent from parent or legal guardian;
6. Participant and family have the ability to comply with the protocol requirements, in the opinion of the investigator.
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Minimum age
6
Years
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Maximum age
18
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Non-English speaking parents;
2. Psychosis;
3. Taking clobazam, mTOR inhibitors (e.g sirolimus, tacrolimus), anti-cancer agents, citalopram >20mg/day, escitalopram >10mg/day.;
4. Abnormal liver function tests: defined as ALT > twice ULN;
5. Abnormal renal function tests: defined as creatinine > ULN
6. Current use of medicinal cannabis, or use in the 4 weeks prior to screening;
7. Pregnant or intending to become pregnant during the study, or breastfeeding;
8. Known allergy to cannabidiol or cannabis products
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
11/05/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/06/2025
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Actual
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Sample size
Target
140
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [2]
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Monash Children's Hospital - Clayton
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Recruitment hospital [3]
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Royal Children's Hospital / Murdoch Children's Research Institute - Parkville
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Recruitment postcode(s) [1]
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2145 - Westmead
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Recruitment postcode(s) [2]
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3168 - Clayton
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Recruitment postcode(s) [3]
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3052 - Parkville
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Funding & Sponsors
Primary sponsor type
Other
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Name
Murdoch Childrens Research Institute
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Monash University
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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University of Sydney
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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Deakin University
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Address [3]
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Country [3]
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a multi-site, double-blind, parallel group, randomized, placebo-controlled study of 140 participants comparing oral purified cannabidiol isolate (CBD) with placebo in reducing Severe Behavioral Problems (SBP) at 8 weeks in children aged 6 - 18 years with Intellectual Disability (ID). Eligible participants will be randomized 1:1 to receive either CBD or placebo.
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Trial website
https://clinicaltrials.gov/study/NCT04821856
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Trial related presentations / publications
Efron D, Taylor K, Payne JM, Freeman JL, Cranswick N, Mulraney M, Prakash C, Lee KJ, Williams K. Does cannabidiol reduce severe behavioural problems in children with intellectual disability? Study protocol for a pilot single-site phase I/II randomised placebo controlled trial. BMJ Open. 2020 Mar 8;10(3):e034362. doi: 10.1136/bmjopen-2019-034362. Efron D, Freeman JL, Cranswick N, Payne JM, Mulraney M, Prakash C, Lee KJ, Taylor K, Williams K. A pilot randomised placebo-controlled trial of cannabidiol to reduce severe behavioural problems in children and adolescents with intellectual disability. Br J Clin Pharmacol. 2021 Feb;87(2):436-446. doi: 10.1111/bcp.14399. Epub 2020 Jul 1.
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Public notes
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Contacts
Principal investigator
Name
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Daryl Efron
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Address
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Murdoch Childrens Research Institute
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Daryl Efron
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Address
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Country
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Phone
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+61 (3) 8341 6200
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
The de-identified data set collected for this analysis of the RCT of CBD in children and adolescents with ID will be available six months after publication of the primary outcome. The study protocol and analysis plan will also be available. The data must be obtained from the Murdoch Children's Research Institute. Prior to releasing any data the following are required: a data access agreement must be signed between relevant parties, the 'RCT of CBD in children and adolescents with ID' Trial Steering Committee must see and approve the data analysis plan describing how the data will be analysed, there must be an agreement around appropriate acknowledgment and any additional costs involved must be covered. Should the Trial Steering Committee be unavailable, this role is delegated to the Murdoch Children's Research Institute. Data will only be shared with a recognized research organisation which has approved the proposed analysis plan.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP)
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When will data be available (start and end dates)?
6 months after publication of primary outcome
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Available to whom?
1) Data access agreement; 2) approval by Trial Steering Committee; 3) recognized research institutions.
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04821856