Guanfacine for Hyperactivity in Children With Down Syndrome (HYPEbeGONE_DS)

Launched by RACHEL G. GREENBERG, MD, MB, MHS · Sep 11, 2023

Keywords

ClinConnect Summary

The clinical trial titled "Guanfacine for Hyperactivity in Children with Down Syndrome" aims to find out if a medication called guanfacine can help treat hyperactivity, impulsivity, and inattention in children aged 6 to 12 with Down syndrome. The study will last for 8 weeks, and researchers will measure how well the medication works in improving these symptoms. The trial is currently looking for participants, which means they are inviting families to consider joining.

To be eligible, children must have a confirmed diagnosis of Down syndrome and show significant signs of hyperactivity and impulsivity. They should weigh at least 25 kg and not have taken guanfacine or certain other medications recently. Parents or guardians need to give their consent for their child to participate, and children who are 8 years or older may need to agree to participate as well. Participants will follow a specific medication schedule and attend regular check-ups to monitor their progress. If you think your child might qualify or if you have questions, it’s a good idea to talk to your doctor for more information.

Gender

ALL

Eligibility criteria

• Inclusion:
• • 1. Parent/Legal Guardian can understand the consent process and is willing to provide informed consent/HIPAA authorization prior to the conduct of any study-related procedures. When applicable, the minor participant is willing to provide assent.
• • 2. Participant has clinical diagnosis of non-mosaic DS.
• • 3. Participant is between 6 and 12 years of age (inclusive) at time of consent.
• • 4. Participant weight is ≥ 25 kg.
• 5. Participant has clinically significant symptoms of hyperactivity, inattention and impulsivity manifested as minimum scores of the following rating scales within 30 days of randomization:
• • 1. A minimum score of 18 on the parent-reported ABC-H subscale, AND
• • 2. A minimum score of moderate or greater (≥ 4) on the clinician reported Clinical Global Impression Severity (CGI-S) score specific to hyperactivity, inattention and impulsivity behaviors.
• • 6. Participant has co-morbid medical screening and clearance to proceed with a non-stimulant medication trial with GIR within 30 days of randomization.
• • 7. Participant is willing and able to comply with study procedures, including adherence to medication dosing schedule.
• Exclusion:
• • 1. Participant has received guanfacine (any formulation) within 30 days of randomization.
• 2. Participant has received any of the following concomitant medication classes within 30 days of randomization:
• • 1. Strong CYP3A4 inhibitors (e.g., boceprevir, clarithromycin, conivaptan, grapefruit juice, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, mibefradil, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole)
• • 2. Strong CYP3A4 inducers (e.g., avasimibe, carbamazepine, phenytoin, rifampin, and St. John's wort)
• • 3. Participant has a psychiatric comorbidity, such as major depressive disorder, bipolar disorder, obsessive-compulsive disorder, or a psychotic disorder, that requires a pharmacological treatment other than guanfacine
• • 4. For participants ≥ 8 years old at the time of consent, participant has a history of suicidality or positive screen on Ask Suicide-Screening Questions (asQ) Tool.
• • 5. Participant is currently in or plans to participate in another interventional study.
• • 6. Participant has a known hypersensitivity to guanfacine.
• • 7. Participant has had a previous guanfacine treatment failure, as determined by their primary treating physician.
• • 8. Participant has had a change in another medication intended to treat symptoms of hyperactivity, inattention, and impulsivity within the last 2 weeks.
• • 9. Participant has had a seizure within the last 6 months.
• • 10. Participant has had a change in their anti-convulsant dose within the last 4 weeks.
• 11. Participant has a cardiac-related condition including:
• • 1. Significant symptomatic bradycardia;
• • 2. 2nd degree or 3rd degree (complete) heart block;
• • 3. Baseline heart rate (HR) or systolic blood pressure (BP) \> 2 standard deviations (SD) below mean for age as determined by medical examination;
• • 4. History of aborted sudden cardiac death, unexplained syncope or near syncope, or historical use of a pacemaker as determined by medical history will require clearance by cardiology prior to enrollment;
• • 5. Known history of congenital heart disease which requires ongoing care for monitoring or management will require clearance by cardiology prior to enrollment.
• • 12. Participant has a history of untreated severe obstructive sleep apnea defined as obstructive apnea hypopnea index (OAHI) ≥ 10 events per hour or aortic regurgitation (AR). Participants with an OAHI index \> 10/hr are eligible if managed with continuous positive airway pressure (CPAP).
• • 13. Participant has untreated thyroid disease.
• • 14. Participant has a known hepatic impairment defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \> 2x the upper limit of normal (ULN) for age.
• 15. Participant has known impending or renal failure defined as:
• • 1. Anuria diagnosed within 12 hours prior to enrollment;
• • 2. Requiring renal replacement therapy.
• • 16. Participant is pregnant.
• • 17. Participant has any condition which would make the participant, in the opinion of the investigator, unsuitable for the study.