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Cannabidivarin (CBDV) vs. Placebo in Children With Autism Spectrum Disorder (ASD)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03202303
Recruitment Status : Recruiting
First Posted : June 28, 2017
Last Update Posted : August 25, 2020
United States Department of Defense
GW Pharmaceuticals Ltd.
Information provided by (Responsible Party):
Eric Hollander, Montefiore Medical Center

Brief Summary:
This trial aims to study the efficacy and safety of cannabidivarin (CBDV) in children with ASD.

Condition or disease Intervention/treatment Phase
Autism Spectrum Disorder Drug: Cannabidivarin Drug: Matched Placebo Phase 2

Detailed Description:

There is a clear unmet need for new therapeutics to treat irritability in children with ASD that do not have the metabolic and weight adverse event profiles of the currently approved treatments. Cannabidivarin (CBDV) is a nonpsychoactive phytocannabinoid and a safe variant of Cannabidiol (CBD). It has no appreciable tetrahydrocannabinol (THC) [less than 0.01%], has been shown to have no impact on weight or metabolism, and improves both social and cognitive functioning in animal models of idiopathic and syndromal autism (Fragile X, Rett Syndrome, Angelman Syndrome). The CDC currently estimates 1 in 59 children have ASD. ASD is characterized by deficits in social communication, irritability, repetitive behaviors, impulsivity, temper tantrums, and high caregiver burden. Currently, the only FDA-approved medications for symptoms of ASD are aripiprazole and risperidone, both of which are indicated for irritability in pediatric ASD. These medications are effective but are associated with considerable side effects with long term treatment in this chronic developmental disorder, including weight gain, metabolic syndrome and the risk of type 2 diabetes, prolactin elevation and growth of breast tissue, extrapyramidal symptoms and the risk of tardive dyskinesia. The anticonvulsant divalproex sodium (valproate/VPA) also significantly reduces irritability and repetitive behaviors in individuals with ASD. Although VPA is efficacious for pediatric epilepsy and some symptoms of ASD, it also has significant side effects, including weight gain, sedation and nausea. CBDV, like VPA, is effective in the treatment of pediatric epilepsy, and ASD mouse models demonstrate potential mechanisms for treatment with CBDV, including potential therapeutic effects on repetitive behaviors, irritability, sociability, and quality of life, and the capacity to reduce inflammation. This study aims to examine the efficacy and safety of cannabidivarin (CBDV) with a primary aim of studying its effect on irritability in children with ASD.

STUDY DESIGN: This is a 12-week randomized, double-blind study of CBDV vs. placebo in 100 child and adolescent subjects aged 5 to 18 years with a diagnosis of ASD.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Phase 2, 12-week double-blind, randomized, placebo-controlled trial
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: Double-Blind
Primary Purpose: Treatment
Official Title: Cannabidivarin (CBDV) vs. Placebo in Children With Autism Spectrum Disorder (ASD)
Actual Study Start Date : April 12, 2019
Estimated Primary Completion Date : June 30, 2021
Estimated Study Completion Date : September 30, 2021

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Cannabidivarin (CBDV)
Weight-based dosing of 10 mg/kg/day of CBDV for 12 weeks
Drug: Cannabidivarin
Weight-based dosing of 10 mg/kg/day of CBDV
Other Name: CBDV

Placebo Comparator: Matched Placebo
Weight-based dosing of 10 mg/kg/day of placebo for 12 weeks
Drug: Matched Placebo
Weight-based dosing of 10 mg/kg/day of placebo
Other Name: Placebo

Primary Outcome Measures :
  1. Aberrant Behavior Checklist-Irritability Subscale (ABC-I) [ Time Frame: Change in ABC-I from Baseline to Week 12 (Change over 12 weeks) ]
    Change in ABC-I from Baseline to Endpoint

Secondary Outcome Measures :
  1. Repetitive Behavior Scale-Revised (RBS-R) [ Time Frame: Change in RBS-R from Baseline to Week 12 (Change over 12 weeks) ]
    Change in RBS-R from Baseline to Endpoint

  2. Aberrant Behavior Checklist-Social Withdrawal Subscale (ABC-SW) [ Time Frame: Change in ABC-SW from Baseline to Week 12 (Change over 12 weeks) ]
    Change in ABC-SW from Baseline to Endpoint

  3. Pediatric Quality of Life Inventory (PedsQL) Family Impact Module [ Time Frame: Change in PedsQL from Baseline to Week 12 (Change over 12 weeks) ]
    Change in PedsQL from Baseline to Endpoint

  4. Vineland Adaptive Behavior Scale-3 (Vineland 3) [ Time Frame: Change in Vineland-3 from Baseline to Week 12 (Change over 12 weeks) ]
    Change in Vineland-3 from Baseline to Endpoint

  5. Clinical Global Impressions-Improvement (CGI-I) [ Time Frame: Change in CGI-I from Baseline to Week 12 (Change over 12 weeks) ]
    Change in CGI-I from Baseline to Endpoint

  6. Montefiore Einstein Rigidity Scale-Revised (MERS-R) [ Time Frame: Change in MERS-R from Baseline to Week 12 (Change over 12 weeks) ]
    The MERS-R is designed to assess three domains of rigid behavior in children and adults with ASD: 1. Behavioral Rigidity (e.g., insistence on sameness, things must be done in his/her way, etc.) 2. Cognitive Rigidity (e.g., special interests, inflexible adherence to rules, etc.) 3. Protest (in response to deviation from rigidity; e.g., verbal objection, tantrum, physical aggression).

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   5 Years to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Male or Female pediatric outpatients aged 5 to 18 years old
  2. Diagnosis of Autism Spectrum Disorder (ASD) confirmed by the ADOS-2 and DSM-5 criteria.*During special circumstances (e.g. COVID-19 pandemic) where the ADOS-2 cannot be performed due to site restrictions (e.g. mandatory use of face masks), eligibility can be confirmed using the Autism Diagnostic Interview, Revised (ADI-R)
  3. Aberrant Behavior Checklist (ABC) - Irritability Subscale score of 18 or greater at screening visit
  4. Social Responsiveness Scale (SRS) score of 66T or higher at screening visit
  5. Clinical Global Impression Scale - Severity (CGI-S) score of 4 or higher at screening
  6. Stable pharmacologic, educational, behavioral and/or dietary interventions for 4 weeks prior to randomization and for the duration of the study.
  7. Physical exam and laboratory results that are within normal range for individuals with ASD
  8. Presence of a parent/caregiver/guardian that is able to consent for their participation and complete assessments regarding the child's development and behavior throughout the study

Exclusion Criteria:

  1. Exposure to any investigational agent in the 30 days prior to randomization.
  2. Prior chronic treatment with CBD, CBDV or an endocannabinoid treatment.
  3. Positive testing for THC or other drugs of abuse at the screening or baseline visits upon repeat confirmation testing.
  4. Recent history of drug abuse including marijuana/cannabis use in the past 3 months.
  5. Diagnosis of a known genetic disorder (ie. Prader-Willi Syndrome, Angelman Syndrome etc.)
  6. A primary psychiatric diagnosis other than ASD, including bipolar disorder, psychosis, schizophrenia, PTSD or MDD. These patients will be excluded due to potential confounding results.
  7. Pregnant or lactating patients or patients who will not agree to be abstinent or use a double barrier method of contraception. CBDV has not been studied in pregnant or lactating women.
  8. A medical condition that severely impacts the subject's ability to participate in the study, interferes with the conduct of the study, confounds interpretation of study results or endangers the subject's well-being.
  9. A known diagnosis of Rett Syndrome or Childhood Disintegrative Disorder, or marked sensory impairment such as deafness or blindness.
  10. Subjects who have had changes in allied health therapies, behavioral or educational interventions within four weeks prior to randomization other than those associated with school holidays.
  11. Subjects who have had changes in medications or medication doses within four weeks of randomization. Renal, pancreatic, or hematologic dysfunction as evidenced by values above upper limits of normal for BUN/creatinine, or values twice the upper limit of normal for serum lipase and amylase, platelets <80,000 /mcL, or WBC<3.0 103 /mcL
  12. Liver dysfunction manifested by > 2 X UNL values of AST or ALT
  13. ECG abnormality at baseline screening or clinically significant postural drop in systolic blood pressure at screening. If the initial screening ECG show a QTcB of greater than 460 msec, then 2 additional ECGs will be conducted in the same sitting, 5 minutes apart. If not recognized at screening, then a full triplicate repeat showing an average QTcB of 460 msec or less to meet all inclusion/exclusion criteria.
  14. Known allergy to sesame oil

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03202303

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Contact: Erin Shanahan, BS 718-839-7520
Contact: Bonnie P Taylor, PhD 718-839-7530

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United States, New York
Montefiore Medical Center Recruiting
Bronx, New York, United States, 10467
Contact: Bonnie Taylor, PhD    718-839-7530   
Contact: Erin Shanahan, BS    718-839-7520   
Sponsors and Collaborators
Eric Hollander
United States Department of Defense
GW Pharmaceuticals Ltd.
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Principal Investigator: Eric Hollander, MD Montefiore Medical Center/Albert Einstein College of Medicine
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Responsible Party: Eric Hollander, Professor, Psychiatry and Behavioral Sciences, Montefiore Medical Center Identifier: NCT03202303    
Other Study ID Numbers: 2017-8538
AR160104 ( Other Grant/Funding Number: Department of Defense (DOD) )
G32379 ( Other Grant/Funding Number: GW Pharmaceuticals )
First Posted: June 28, 2017    Key Record Dates
Last Update Posted: August 25, 2020
Last Verified: August 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Eric Hollander, Montefiore Medical Center:
Additional relevant MeSH terms:
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Autistic Disorder
Autism Spectrum Disorder
Child Development Disorders, Pervasive
Neurodevelopmental Disorders
Mental Disorders