RecruitingPhase 4NCT05916339

AWARE: Management of ADHD in Autism Spectrum Disorder

Comparative Effectiveness of Pharmacologic Management of ADHD in Children and Youth With Autism Spectrum Disorder


Sponsor

Daniel Coury

Enrollment

500 participants

Start Date

Oct 1, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

This study is a pragmatic clinical trial examining the comparative effectiveness of two stimulant medications (methylphenidate and amphetamine) in the treatment of ADHD in children and adolescents with autism. Using a sequential, multiple assignment randomization trial (SMART) design the study will not only assess these two medications but also the role of an increasingly popular class of ADHD medication, the alpha-2 agonists. Findings from this study will help improve clinicians' approach to medication selection and reduce the repeated trials of multiple medications that are current standard care.


Eligibility

Min Age: 4 YearsMax Age: 17 Years

Inclusion Criteria10

  • Participant and/or legal caregiver must be willing and able to give informed consent/assent for participation in this study.
  • Participant and/or legal caregiver must be willing and able (in the Investigator's opinion) to comply with all study requirements.
  • Participant must be between 4 and 17 years of age (inclusive) at time of enrollment.
  • Participant must have a confirmed diagnosis of ASD based on supportive evidence (e.g. referring physician's report, medical records, such as ADOS or CARS, etc.).
  • Participant must have the ability to consistently take medication (via pill, liquid or mixed with food/liquid).
  • Participant must have a confirmed diagnosis of ADHD (based upon DSM-5 criteria and supportive evidence).
  • Participant must have a consistent reporter (e.g., parent) who spends regular time with the child.
  • Participant can be on other psychotropic medications (selective serotonin reuptake inhibitor (SSRI), atypical antipsychotic, anticonvulsant) if dose has been stable for > 4 weeks prior to consent with no plans for a dose change during the study.
  • It has been at least 7 days since the participant last took an ADHD medication and the presiding clinician believes this to be a sufficient amount of time.
  • Caregiver must be sufficiently fluent in English or Spanish to be able to complete questionnaires relevant to this study.

Exclusion Criteria3

  • Participant has taken ADHD medication within the past 7 days.
  • Participant is not stable on other medications (< 4 weeks).
  • Any other risk factor that might prevent patient from safely taking the study medications.

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Interventions

DRUGRandomization to either Amphetamine (AMP) class of stimulant medication or Methylphenidate (MPH) class of stimulant medication

Amphetamine (AMP) medication names: Adderall, Adderall XR, Adzenys ER, Adzenys XR-ODT, Dayanavel XR, Dexedrine (spansule), Dexedrine (tablet), Mydayis, Procentra liquid Methylphenidate (MPH) medication names: Adhansia XR, Aptensio XR, Azstarys, Concerta, Cotempla XR-ODT, Daytrana, Focalin, Focalin XR, Jornay PM. Metadate CD, Methylin (liquid), Ritalin, Ritalin LA, Quillichew ER, Quillivant XR (liquid)

DRUGRandomization to either Alpha 2 agonist class of medication or alternate class of stimulant.

If first line stimulant therapy (Amphetamine/Methylphenidate) is deemed not effective or tolerable, re-randomization to the alternate stimulant or alpha-2 agonist will occur. If participant is satisfied with first line stimulant treatment, first-line stimulant therapy will continue. Catapres, Clonidine, Guanfacine, Intuniv, Kapvay, Tenex


Locations(12)

University of California, Irvine

Irvine, California, United States

Children's Hospital Los Angeles

Los Angeles, California, United States

Maine Medical Center

Portland, Maine, United States

Massachusetts General Hospital Lurie Center for Autism

Boston, Massachusetts, United States

University of Rochester

Rochester, New York, United States

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Nationwide Children's Hospital

Columbus, Ohio, United States

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

University of Virginia

Charlottesville, Virginia, United States

University of Alberta, Glenrose Rehabilitation Hospital

Edmonton, Canada

Holland Bloorview Kids Rehabilitation Hospital

Toronto, Canada

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NCT05916339


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