A randomized, double-blind, placebo-controlled phase II trial to explore the effects of a GABAA-α5 NAM (basmisanil) on intellectual disability associated with Down syndrome
dc.contributor.author | Goeldner, C | |
dc.contributor.author | Kishnani, PS | |
dc.contributor.author | Skotko, BG | |
dc.contributor.author | Casero, JL | |
dc.contributor.author | Hipp, JF | |
dc.contributor.author | Derks, M | |
dc.contributor.author | Hernandez, M-C | |
dc.contributor.author | Khwaja, O | |
dc.contributor.author | Lennon-Chrimes, S | |
dc.contributor.author | Noeldeke, J | |
dc.contributor.author | Pellicer, S | |
dc.contributor.author | Squassante, L | |
dc.contributor.author | Visootsak, J | |
dc.contributor.author | Wandel, C | |
dc.contributor.author | Fontoura, P | |
dc.contributor.author | d’Ardhuy, XL | |
dc.contributor.author | De La Torre Fornell, R | |
dc.contributor.author | Glue, P | |
dc.contributor.author | Hoover-Fong, J | |
dc.contributor.author | Uhlmann, S | |
dc.contributor.author | Malagón Valdez, J | |
dc.contributor.author | Marshall, A | |
dc.contributor.author | Martinón-Torres, F | |
dc.contributor.author | Redondo-Collazo, L | |
dc.contributor.author | Rodriguez-Tenreiro, C | |
dc.contributor.author | Marquez Chin, V | |
dc.contributor.author | Michel Reynoso, AG | |
dc.contributor.author | Mitchell, EA | |
dc.contributor.author | Slykerman, RF | |
dc.contributor.author | Wouldes, T | |
dc.contributor.author | Loveday, S | |
dc.contributor.author | Moldenhauer, F | |
dc.contributor.author | Novell, R | |
dc.contributor.author | Ochoa, C | |
dc.contributor.author | Rafii, MS | |
dc.contributor.author | Rebillat, A-S | |
dc.contributor.author | Sanlaville, D | |
dc.contributor.author | Sarda, P | |
dc.contributor.author | Shankar, R | |
dc.contributor.author | Pulsifer, M | |
dc.contributor.author | Evans, CL | |
dc.contributor.author | Silva, AM | |
dc.contributor.author | McDonough, ME | |
dc.contributor.author | Stanley, M | |
dc.contributor.author | McCary, LM | |
dc.contributor.author | Vicari, S | |
dc.contributor.author | Wilcox, W | |
dc.contributor.author | Zampino, G | |
dc.contributor.author | Zuddas, A | |
dc.date.accessioned | 2023-08-23T17:10:39Z | |
dc.date.available | 2023-08-23T17:10:39Z | |
dc.date.issued | 2022-12 | |
dc.identifier.issn | 1866-1947 | |
dc.identifier.issn | 1866-1955 | |
dc.identifier.other | 10 | |
dc.identifier.uri | https://pearl.plymouth.ac.uk/handle/10026.1/21258 | |
dc.description.abstract |
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>There are currently no pharmacological therapies to address the intellectual disability associated with Down syndrome. Excitatory/inhibitory imbalance has been hypothesized to contribute to impairments in cognitive functioning in Down syndrome. Negative modulation of the GABA<jats:sub>A</jats:sub>-α5 receptor is proposed as a mechanism to attenuate GABAergic function and restore the excitatory/inhibitory balance.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Basmisanil, a selective GABA<jats:sub>A</jats:sub>-α5 negative allosteric modulator, was evaluated at 120 mg or 240 mg BID (80 or 160 mg for 12–13 years) in a 6-month, randomized, double-blind, placebo-controlled phase II trial (Clematis) for efficacy and safety in adolescents and young adults with Down syndrome. The primary endpoint was based on a composite analysis of working memory (Repeatable Battery for the Assessment of Neuropsychological Scale [RBANS]) and independent functioning and adaptive behavior (Vineland Adaptive Behavior Scales [VABS-II] or the Clinical Global Impression-Improvement [CGI-I]). Secondary measures included the Behavior Rating Inventory of Executive Functioning-Preschool (BRIEF-P), Clinical Evaluation of Language Fundamentals (CELF-4), and Pediatric Quality of Life Inventory (Peds-QL). EEG was conducted for safety monitoring and quantitatively analyzed in adolescents.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Basmisanil was safe and well-tolerated; the frequency and nature of adverse events were similar in basmisanil and placebo arms. EEG revealed treatment-related changes in spectral power (increase in low ~ 4-Hz and decrease in high ~ 20-Hz frequencies) providing evidence of functional target engagement. All treatment arms had a similar proportion of participants showing above-threshold improvement on the primary composite endpoint, evaluating concomitant responses in cognition and independent functioning (29% in placebo, 20% in low dose, and 25% in high dose). Further analysis of the individual measures contributing to the primary endpoint revealed no difference between placebo and basmisanil-treated groups in either adolescents or adults. There were also no differences across the secondary endpoints assessing changes in executive function, language, or quality of life.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Basmisanil did not meet the primary efficacy objective of concomitant improvement on cognition and adaptive functioning after 6 months of treatment, despite evidence for target engagement. This study provides key learnings for future clinical trials in Down syndrome.</jats:p> </jats:sec><jats:sec> <jats:title>Trial registration</jats:title> <jats:p>The study was registered on December 31, 2013, at clinicaltrials.gov as NCT02024789.</jats:p> </jats:sec> | |
dc.format.extent | 10- | |
dc.format.medium | Electronic | |
dc.language | en | |
dc.publisher | Springer Science and Business Media LLC | |
dc.subject | Down syndrome | |
dc.subject | GABA(A)-alpha 5 | |
dc.subject | Cognition | |
dc.subject | Adaptive behavior | |
dc.subject | EEG | |
dc.title | A randomized, double-blind, placebo-controlled phase II trial to explore the effects of a GABAA-α5 NAM (basmisanil) on intellectual disability associated with Down syndrome | |
dc.type | journal-article | |
dc.type | Article | |
plymouth.author-url | https://www.ncbi.nlm.nih.gov/pubmed/35123401 | |
plymouth.issue | 1 | |
plymouth.volume | 14 | |
plymouth.publication-status | Published | |
plymouth.journal | Journal of Neurodevelopmental Disorders | |
dc.identifier.doi | 10.1186/s11689-022-09418-0 | |
plymouth.organisational-group | |Plymouth | |
plymouth.organisational-group | |Plymouth|Faculty of Health | |
plymouth.organisational-group | |Plymouth|Users by role | |
dc.publisher.place | England | |
dcterms.dateAccepted | 2022-01-12 | |
dc.date.updated | 2023-08-23T17:10:39Z | |
dc.rights.embargodate | 10000-01-01 | |
dc.identifier.eissn | 1866-1955 | |
dc.rights.embargoperiod | forever | |
rioxxterms.versionofrecord | 10.1186/s11689-022-09418-0 |