AFQ056 for Language Learning in Children With FXS



Status:Recruiting
Conditions:Other Indications
Therapuetic Areas:Other
Healthy:No
Age Range:Any - 6
Updated:8/31/2018
Start Date:August 17, 2017
End Date:July 1, 2020
Contact:Katherine J Friedmann, RN
Email:katherine_j_friedmann@rush.edu
Phone:312-942-9841

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Effects of AFQ056 on Language Learning in Young Children With Fragile X Syndrome (FXS)

The overall goals are to change the paradigm for development of mechanism targeted
pharmacotherapy in neurodevelopmental disorders and provide a definitive test of the mGluR
theory in humans by determining whether AFQ056, an mGluR5 negative modulator, can enhance
neural plasticity in the form of language learning during an intensive language intervention
in very young children with fragile X syndrome. This trial therefore will use an innovative
but exploratory new trial design to develop a different way to examine efficacy of an agent
with substantial support as a drug targeting CNS plasticity in preclinical models of a
developmental disorder. If the design is successful, this trial can serve as a model for
future trials of mechanistically-targeted treatments operating on neural plasticity in other
neurodevelopmental disorders.

The trial will use a double blind placebo-controlled parallel-group flexible-dose forced
titration design in which 100 subjects with FXS, age 32 months to 6 years of age will enter a
12-month blinded treatment phase during which they are randomized 1:1 to AFQ056 or placebo
followed by an 8-month (open label) extension phase in which all participants will be treated
with active drug. The flexible dose design will mimic practice, take into account
differential responsiveness and the known inter-child variability in drug levels with AFQ056,
and allow use of maximum tolerated dose (MTD) which is likely to be most effective.

Inclusion Criteria

1. Age 32 months to 6 years inclusive at Screening (visit 1).

2. Has an FMR1 full mutation.

3. DQ<75 calculated from the Mullen Scales of Early Learning at time of screening.

4. Parent or legal guardian is available and able to communicate well with the
investigator, comply with study requirements and provide written informed consent.

**Note**The Parent or legal guardian who will be signing consent form, should be the
individual administering the language intervention

5. English is the primary language spoken in the home and the subject's first language is
English.

6. Meet criteria indicating evidence of intentional communication based on parent
interview via a communication eligibility screening tool.

**Note** On the Eligibility Screening Tool - Communication, the child must have at
time of screening:

1. Section 1: Answer of YES; the child uses at least 5 spoken words to label items
on a daily basis.

OR

2. Section 2: At least 3 YES answers to items 1-10 if child does not have at least 5
spoken words.

7. Produces 3 or more intentional acts of communication on the structured portion of the
Weighted Communication play sample at time of screening.

8. Stable behavioral and other therapy regimen for 30 days prior to screening.

9. Stable dosing of all concurrent psychotropic medications except stimulants for at
least 60 days prior to screening. Due to the very short half-life of stimulants
(specifically methylphenidate and amphetamine variants), a stable regimen of these
medications is required for 2 weeks only.

- Note** Medications impacting GABA, glutamate and/or mGluR5 pathway receptors are
exclusionary and not permitted during study participation. Additionally,
stimulant regimens may include combinations of short- and long-acting forms and
may be taken with different timing or dosing on different days of the week (e.g.
Doses may be skipped on weekends or days off school and extra doses may be given
some days for therapy sessions later in the day). The intent is to keep the doses
and regimen being used at the time of screening consistent during the trial even
if there is some variation in how the medication is taken on different days.

Exclusion Criteria

1. Use of medications impacting GABA, glutamate and/or mGluR5 pathway receptors or
transmission.

**Note** Treatment with acamprosate, amantadine, budipine, carbetocin, cycloserine,
dextromethorphan, felbamate, ketamine, lithium, minocycline, memantine, oxytocin,
remacemide, racemic baclofen, riluzole, fycampa, investigational mGluR5 medications,
and/or statins are exclusionary.

2. Unstable seizure disorder as defined by any seizure in the 6 months prior to the
screening visit, and/or any change in anti-convulsant drug dosing in the 60 days prior
to screening.

**Note** Use of levetiracetam and oxcarbazepine are among permitted anticonvulsants.

3. Use of any other investigational drug at the time of enrollment or within 30 days or 5
half-lives (whichever is longer) of the investigational drug prior to screening until
end of study visits (or longer if required by local regulations).

4. History of hypersensitivity to AFQ056 or any mGluR antagonist.

5. History or presence of any clinically significant disease of any major system organ
class, within the past 2 years prior to screening including but not limited to
neurological, cardiovascular, endocrine, metabolic, renal, or gastrointestinal
disorders. This does not include typical features of FXS such as psychological
symptoms or history of epileptic seizures.

6. Significant acute illness that did not completely resolve at least four weeks prior to
the Screening visit.

7. Abnormal laboratory values at screening that are in the opinion of the investigator
are clinically significant and may jeopardize the safety of the study subject.

8. Use of (or use within at least 5 half-lives before dosing) concomitant medications
that are strong/moderate inhibitors or inducers of CYP1A1/2, CYP2C9/19 or CYP3A4 (see
Appendix B).

9. Subjects who are, in the opinion of the investigator, unable to comply with the
requirements of the study.

10. History or Ppresence of immunodeficiency diseases at the time of screening, based on
medical history, including a positive HIV test result.

11. History of a positive Hepatitis B surface antigen (HBsAg) or Hepatitis C result at
time of screening.

12. History or presence of suicidal thoughts and/or suicide attempts.
We found this trial at
13
sites
111 Michigan Ave NW
Washington, District of Columbia
(202) 476-5000
Principal Investigator: Andrea Gropman, MD
Phone: 202-476-6551
Childrens National Medical Center As the nation’s children’s hospital, the mission of Children’s National Medical...
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201 Dowman Dr
Atlanta, Georgia 30303
(404) 727-6123
Principal Investigator: Amy Talboy, MD
Phone: 404-778-8619
Emory University Emory University, recognized internationally for its outstanding liberal artscolleges, graduate and professional schools,...
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Atlanta, GA
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3333 Burnet Avenue # Mlc3008
Cincinnati, Ohio 45229
 1-513-636-4200 
Principal Investigator: Craig Erickson, MD
Phone: 513-636-0526
Cincinnati Children's Hospital Medical Center Patients and families from across the region and around the...
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Cincinnati, OH
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700 Childrens Drive
Columbus, Ohio 43205
(616) 722-2000
Principal Investigator: Lenora Lehwald, MD
Phone: 614-722-4684
Nationwide Children's Hospital At Nationwide Children’s, we are creating the future of pediatric health care....
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Columbus, OH
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1211 Medical Center Dr
Nashville, Tennessee 37232
(615) 322-5000
Principal Investigator: Angela Maxwell-Horn, MD
Phone: 615-343-4590
Vanderbilt Univ Med Ctr Vanderbilt University Medical Center (VUMC) is a comprehensive healthcare facility dedicated...
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Nashville, TN
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300 Longwood Ave
Boston, Massachusetts 02115
(617) 355-6000
Principal Investigator: Lisa Prock, MD, MPH
Phone: 857-218-5472
Boston Children's Hospital Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care....
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Boston, MA
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1653 W. Congress Parkway
Chicago, Illinois 60612
(312) 942-5000
Phone: 312-942-9841
Rush University Medical Center Rush University Medical Center encompasses a 664-bed hospital serving adults and...
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Dallas, Texas 75390
Principal Investigator: Sailaja Golla, MBBS
Phone: 214-648-2926
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Davis, California 95616
Principal Investigator: Randi Hagerman, MD
Phone: 916-703-0281
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Denver, Colorado 80045
Principal Investigator: Nicole Tartaglia, MD
Phone: 720-777-8606
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New York, New York 10605
Principal Investigator: Jeremy Veenstra-VanderWeele, MD
Phone: 914-997-5242
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3414 Fifth Avenue
Pittsburgh, Pennsylvania 15213
Principal Investigator: Robin Filipink, MD
Phone: 412-383-7549
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Saint Louis, Missouri 63110
Principal Investigator: Bryan McGill, MD, PhD
Phone: 314-362-7166
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