Journal Article

A randomized double-blind, placebo-controlled trial of ganaxolone in children and adolescents with fragile X syndrome

Schneider, Andrea, Ceulemans, Berten, Bickel, Erika S., Nguyen, Danh V., Hagerman, Randi J., Tassone, Flora, Van Dijck, Anke, Kooy, R. Frank, Lozano, Reymundo, Chen, Yanjun, Hessl, David, Angkustsiri, Kathleen, Ligsay, Andrew

2017

Overview

Background Gamma-aminobutyric acid (GABA) system deficits are integral to the pathophysiologic development of fragile X syndrome (FXS). Ganaxolone, a GABA A receptor positive allosteric modulator, is hypothesized to improve symptoms such as anxiety, hyperactivity, and attention deficits in children with FXS. Methods This study was a randomized, double-blind, placebo-controlled, crossover trial of ganaxolone in children with FXS, aged 6–17 years. Results Sixty-one participants were assessed for eligibility, and 59 were randomized to the study. Fifty-five participants completed at least the first arm and were included in the intention-to-treat analysis; 51 participants completed both treatment arms. There were no statistically significant improvements observed on the primary outcome measure (Clinical Global Impression-Improvement), the key secondary outcome measure (Pediatric Anxiety Rating Scale-R), or any other secondary outcome measures in the overall study population. However, post-hoc analyses revealed positive trends in areas of anxiety, attention, and hyperactivity in participants with higher baseline anxiety and low full-scale IQ scores. No serious adverse events (AEs) occurred, although there was a significant increase in the frequency and severity of AEs related to ganaxolone compared to placebo. Conclusions While ganaxolone was found to be safe, there were no significant improvements in the outcome measures in the overall study population. However, ganaxolone in subgroups of children with FXS, including those with higher anxiety or lower cognitive abilities, might have beneficial effects. Trial registration ClinicalTrials.gov, NCT01725152

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescents / Allosteric properties / Anxiety / Autism / Behavior / Binding sites / Biomedical and Life Sciences / Biomedicine / Children / Children & youth / Clinical trial / Clinical trials / Cognitive ability / Complications and side effects / Design / Double-blind studies / Drug therapy / Epilepsy / Fragile X syndrome / Ganaxolone / Human Genetics / Hyperactivity / Intellectual disabilities / Intelligence tests / Males / Motivation / Neurology / Neuropsychology / Neurosciences / Pediatrics / Population studies / Psychiatry / Psychological aspects / Psychopharmacology / Quantitative psychology / Rodents / Statistical analysis / Teenagers / γ-Aminobutyric acid A receptors